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C 53- KPWTl-54/.(^>3M7 



RECEIVED 



iUL 10 1989 
W LIBRARY 



NORTH CAROLINA 

REGISTER 



IN THIS ISSUE 



EXECUTIVE ORDER 



FINAL DECISION LETTER 




PROPOSED RULES 

Commerce 
Cultural Resources 
Human Resources 
Landscape Architects 
NRCD 

FINAL RULES 

List of Rules Codified 

ISSUE DATE: JULY 3, 1 989 

Volume 4 • Issue 7 • Pages 365-454 



INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATIVE CODE 



NORTH CAROLINA REGISTER 

The North Carolina Register is published bi-monthly 
and contains information relating to agency, executive, 
legislative and judicial actions required by or affecting 
Chapter 150B of the General Statutes. All proposed, ad- 
ministrative rules and amendments filed under Chapter 
150B must be published in the Register. The Register 
will typically comprise appro.ximately fifty pages per 
issue of legal text. 

State law requires that a copy of each issue be pro- 
vided free of charge to each county in the state and to 
various state officials and institutions. The North Carolina 
Register is available by yearly subscription at a cost of 
one hundred and five dollars ($105.00) for 24 issues. 

Requests for subscriptions to the North Carolina 
Register should be directed to the Office of Ad- 
ministrative Hearings, P. O. Drawer 11666, Raleigh, N. 
C. 27604, Attn: Subscriptions. 

ADOPTION, AMENDMENT, AND REPEAL OF 
RULES 

An agency intending to adopt, amend, or repeal a rule 
must first publish notice of the proposed action in the 
North Carolina Register. The notice must include the 
time and place of the public hearing; a statement of how 
public comments may be submitted to the agency either 
at the hearing or otherwise; the text of the proposed 
rule or amendment; a reference to the Statutory 
Authority for the action and the proposed effective date. 

The Director of the Office of Administrative Hearings 
has authority to publish a summary, rather than the 
full text, of any amendment which is considered to be 
too lengthy. In such case, the full text of the rule con- 
taining the proposed amendment will be available for 
public inspection at the Rules Division of the Office of 
Administrative Hearings and at the office of the pro- 
mulgating agency. 

Unless a specific statute provides otherwise, at least 
30 days must elapse following publication of the pro- 
posal in the North Carolina Register before the agency 
may conduct the required public hearing and take ac- 
tion on the proposed adoption, amendment or repeal. 

When final action is taken, the promulgating agency 
must file any adopted or amended rule for approval by 
the Administrative Rules Review Commission. Upon ap- 
proval of ARRC, the adopted or amended rule must be 
filed with the Office of Administrative Hearings. If it 
differs substantially from the proposed form published 
as part of the public notice, upon request by the agen- 
cy, the adopted version will again be published in the 
North Carolina Register. 

A rule, or amended rule cannot become effective 
earlier than the first day of the second calendar month 
after the adoption is filed with the Office of Ad- 
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Proposed action on rules may be withdrawn by the 
promulgating agency at any time before final action is 
taken by the agency. 

TEMPORARY RULES 

Under certain conditions of an emergency nature, 
some agencies may issue temporary rules. A temporary- 
rule becomes effective when adopted and remains in 



effect for the period specified in the rule or 180 da\ 
whichever is less. An agency adopting a temporarv ru 
must begin normal rule-making procedures on the pe 
manent rule at the same time the temporarv rule 
adopted. 

NORTH CAROLINA ADMINISTRATIVE CODE 

The North Carolina Administrative Code (NCAC) 
a compilation and index of the administrative rules o 
25 state agencies and 38 occupational licensing board: 
The NCAC comprises approximately 15,000 letter sizt 
single spaced pages of material of which approximaK 
ly 35% is changed annually. Compilation and public; 
tion of the NCAC is mandated by G.S. l50B-63(b). 

The Code is divided into Titles and Chapters. Eac 
state agency is assigned a separate title which is fu 
ther broken down by chapters. Title 21 is designate 
for occupational licensing boards. 

The NCAC is available in two formats. 

(1) Single pages may be obtained at a minimui 
cost of two dollars and 50 cents ($2.50) for 1 
pages or less, plus fifteen cents ($0. 1 5) per eac 
additional page. 

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one year subscription to the full publication ir 
eluding supplements can be purchased fc 
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dividual volumes may also be purchased wit 
supplement service. Renewal subscriptions fc 
supplements to the initial publication availabl 

Requests for pages of rules or volumes of the NCA 
should be directed to the Office of Administrativ 
Hearings. 

NOTE 

The foregoing is a generalized statement of the pn 
cedures to be followed. For specific statutory languag 
it is suggested that Articles 2 and 5 of Chapter 150B ( 
the General Statutes be examined carefully. 

CITATION TO THE NORTH CAROLINA 
REGISTER 

The North Carolina Register is cited by volume, issu 
page number and date. 1:1 NCR 101-201, April 1, 19J 

refers to Volume 1, Issue 1, pages 101 through 201 < 
the North Carolina Register issued on April 1, 1986 



North Carolina Register. Published bi-monthly by 
the Office of Administrative Hearings, P.O. Drawer 
11666, Raleigh, North Carolina 27604, pursuant to 
Chapter 150B of the General Statutes. Subscriptions 
one hundred and five dollars ($105.00) per year. 
North Carolina Administrative Code. Published 
in looseleaf notebooks with supplement service by 
the Office of Administrative Hearings, P.O. 
Drawer 1 1666, Raleigh, North Carolina 27604, pur- 
suant to Chapter 150B of the General Satutes. 
Subscriptions seven hundred and fifty dollars 
($750.00). Individual volumes available. 



I 



M 



NORTH 
CAROLINA 
REGISTER 



ISSUE CONTENTS 




I. EXECLTTV E ORDER 

Executive Order 92.... 



.365 



II. 



III. 



Office of Administrative Hearings 

P. O. Drawer 11666 

Raleigh, SC 27604 

(919) 733-2678 



Robert A. Melott, 

Director 
James R. Scarcella St., 

Deputy Director 
Molly Masich, 

Director APA Services 



Staff: 

Ruby Creech, 

Publications Coordinator 
Teresa Kilpatrick, 

Editorial Assistant 
Jean Shirley, 

Editorial Assistant 



FINAL DECISION LETTER 

Voting Rights Act 367 



PROPOSED RULES 
Commerce 

Finance Center 368 

Cultural Resources 

Archives and History 370 

Arts Council 371 

Human Resources 

Departmental Rules 372 

Facility Services 377 

Health Services 405 

Mental Health, Mental 
Retardation and Substance 
Abuse Services 417 

Licensing Board 
Landscape Architects 443 

NRCD 
Environmental Management.... 431 



IV. FINAL RULES 

List of Rules Codified 445 



V. CUMULATIVE INDEX 453 



NORTH CAROLINA REGISTER 

Publication Deadlines and Schedules 

(January 1989 - May 1990) 



Issue 


Last Day 


Last Day 


Earliest 


♦ 


Date 


for 


for 


Date for 


Earliest 




Filing 


Electronic 


Public 


Effective 






Filing 


Hearing & 
Adoption by 
Agency 


Date 


******** 


******** 


******** 


♦♦+♦♦♦+♦ 


*******i 


0i;02,89 


12,08/88 


12/15/88 


02,01/89 


05/01/89 


01/16/89 


12/27/88 


01/03/89 


02/15/89 


05/01/89 


02/01 89 


01/10/89 


01/17/89 


03 03/89 


06/01/89 


02/15,89 


01/26,89 


02/02/89 


03/17/89 


06/01 89 


03 0189 


02/08 89 


02/15/89 


03/31/89 


07/01/89 


03/15 89 


02/21/89 


03/02/89 


04/14/89 


07/01/89 


04 03/89 


03/10-89 


03/17/89 


05/03/89 


08/01/89 


04' 14 '89 


03/23/89 


03/31/89 


05/14/89 


08/01/89 


0501 89 


04/10/89 


04/17/89 


05/31/89 


09/01/89 


05 15 89 


04/24/89 


05,01 89 


06/14/89 


09/01/89 


06/01 '89 


05/10/89 


05/17/89 


07/01/89 


10/01/89 


06/15/89 


05/24/89 


06/01/89 


07/15/89 


10/01/89 


07 03 '89 


06/12/89 


06/19/89 


08/01/89 


11/01/89 


07/14-89 


06/22/89 


06/29/89 


08/13,-89 


11/01/89 


08 01 89 


07,11,89 


07/18/89 


08 31 89 


12,01 89 


08 15 89 


07/25,89 


08,01/89 


09 14,89 


12/01,89 


09 0189 


08/11,89 


08/18/89 


10'01/89 


01/01/90 


09 15 89 


08/24,89 


08/31/89 


10' 15, 89 


01/01/90 


10/02/89 


09/11/89 


09/18/89 


11/01/89 


02/01/90 


10 16'89 


09/25/89 


1002/89 


11/1589 


02/01/90 


11,01 89 


10/11/89 


10/1889 


12,01/89 


03 01/90 


11/15,89 


10/24/89 


10/31,89 


12/15/89 


03/01/90 


12/01/89 


11/07,89 


11,15/89 


12/31/89 


04,01/90 


12/ 15,' 89 


11/22/89 


12/01/89 


01/14/90 


04/01/90 


01/02/90 


12/07/89 


12/14/89 


02/01/90 


05/01/90 


01/16 90 


12/20/89 


12/29/89 


02/15/90 


05/01/90 


02 01 '90 


01/10/90 


01/18/90 


03 '03/90 


06/01/90 


02/15/90 


01/25/90 


02/01/90 


03/17/90 


06/01/90 


03 01 '90 


02,08/90 


02/15/90 


03/31/90 


07/01/90 


03/15 90 


02/22/90 


03/01/90 


04/14/90 


07/01/90 


04/02/90 


03/12/90 


03/19/90 


05/02/90 


08/01/90 


04/16/90 


03/23/90 


03'30/90 


05 16 '90 


08/01/90 


05/01/90 


04/09/90 


04/17/90 


05/31/90 


09/01/90 


05/15/90 


04/24/90 


05/01/90 


06/14/90 


09/01/90 



* The "Earliest Effective Date" is computed assuming that the public hearing 
and adoption occur in the calendar month immediately following the "Issue 
Date", that the agency files the rule with The Administrative Rules Review 
Commission by the 20th of the same calendar month and that ARRC approves 
the rule at the next calendar month meeting. 



EXECUTIVE ORDER 



EXECUTIVE ORDER NUMBER 92 

ESTABLISHING THE WESTERN NORTH 
CAROLINA ENVIRONMENTAL COUNCIL 

The counties of Western North Carolina are 
among the most environmentally and econom- 
ically important areas of the State. Like else- 
where in the State, population increases and the 
needs of today's society are bringing changes to 
these counties requiring that choices be made as 
to the means by which the environmental and 
economic needs of the area can best complement 
each other. When such choices are to be made 
it is important that interested parties be fully, 
accurately and timely informed as to all aspects 
of the choices that are to be made and the issues 
that are to be decided. This executive order is to 
provide an effective means for achieving that end. 

THEREFORE, pursuant to authority vested in 
me as Governor by the Constitution and laws of 
North Carohna, it is ORDERED: 

Section h There is hereby created the Western 
North Carolina Environmental Council. The 
purpose of the Council shall be to act as a forum 
in which environmental and economic concerns 
in Westem North Carolina may be openly in- 
quired into and discussed, to the end that inter- 
ested parties may be fully, accurately and timely 
informed as to all aspects of the choices that are 
to be made and the issues that are to be decided 
concerning them. 

Section 2^ As used herein "Westem North 
Carolina" shall include the following counties 
and such other geographical areas as the Council 
from time to time deems appropriate, either on 
a permanent or ad hoc basis: 

Alleghany Macon 

Ashe Swain 

Avery Madison 

Buncombe McDowell 

Burke Mitchell 

Caldwell Polk 

Cherokee Rutherford 

Clay Transylvania 

Graham Watauga 

Haywood Wilkes 

Henderson Yancey 

Jackson 

Section 3^ The Council shall be composed of 
eighteen members in addition to the chairman 
and ex officio members. Council members shall 
be appointed by the Governor and shall consist 
of persons found by the Governor to be inter- 



ested in and knowledgeable about the environ- 
ment and economic aifairs of Westem North 
Carolina. Each member shall serve for such term 
as the Governor shall prescribe in appointing 
him. The Secretaries of the Departments of 
Commerce, Human Resources, Natural Re- 
sources and Community Development and 
Transportation or their designees shall be ex 
officio members of the Council. 

Section 4^ The Lt. Governor shall be chairman 
of the Council. There also shall be a vice- 
chairman appointed by the Governor from 
among the Council members. The chairman and 
vice-chairman shall serve for such terms as the 
Governor shall prescribe. 

Section 5^ The Council shall meet regularly at 
least quarterly at such places, on such dates and 
at such times as the Chairman shall direct. All 
such meetings shall be held in Westem North 
Carolina unless the Council shall direct other- 
wise. Special meetings of the Council shall be 
held on the call of the Chairman at such places, 
on such dates and at such times as the Chairman 
shall direct or at the call of at least a majority of 
the Council members, excluding the Chairman. 

Section 6^ The Chairman, and in his absence 
the Vice-chairman and in both their absences a 
Council member designated by the Chairman, 
shall preside at all Council meetings. Council 
business shall be conducted according to rules 
adopted by the Council at its first meeting. 
Matters coming before the Council that are not 
covered by the rules shall be determined accord- 
ing to Robert's Rules of Order. Minutes of 
Council meetings and the records of the Council 
shall be kept by a Secretary chosen by the 
Council from among its members, or otherwise, 
at the first meeting of the Council. 

Section Jl The Council shall be served by three 
permanent committees and such other commit- 
tees and subcommittees as the Council shall di- 
rect. Committee and subcommittee duties, 
procedures and duration shall be as the Council 
prescribes. Committee and sub-committee 
members shall be appointed by the Chairman. 
The three permanent committees shall be: 

(a) Agenda Committee 

(b) Public Information Committee 

(c) Technical Resource Committee 

Section 8^ In carrying out its purpose the 
CouncU shall: 

(a) At its own initiative or at the request of 
public bodies, public officials or members of the 



NORTH CAROLINA REGISTER 



365 



EXECUTIVE ORDER 



public, select matters of environmental and or 
economic concern to Western North Carolina 
and place them upon the Council agenda for 
consideration. 

(b) Conduct public hearings concerning mat- 
ters up>on the Council agenda at which members 
of the public may present and explain to the 
Council their views. 

(c) Conduct mvestigations into matters upon 
the Council agenda and announce the results of 
their investigations to the public. 

(d) .Make reports concerning matters upon the 
Council agenda to the affected parties, the Gov- 
ernor and other appropriate public officials, per- 
sons requesting such reports and the public. 



ably shall need. The Secretaries of the four de- 
partments shall meet with the Chairman of the 
Council immediately after the date of the Coun- 
cil's first meeting and agree with him as to how 
such staff needs shall be furnished. 

Section 10: Council members shall be reim- 
bursed for necessary travel and subsistence ex- 
penses as authorized under G.S. §138-5 and 
§138-6. Funds for the reimbursement of such 
expenses shall be made available from funds ap- 
propriated to the Departments of Adminis- 
tration, Human Resources, Natural Resources 
and Community Development and Transporta- 
tion as directed by the Director of the Budget. 



Section 9. The administrative departments of 
State Government, including the component 
campuses of the University of North Carolina 
and the Community College System, shall render 
assistance to the Council upon request. The 
Departments of Administration, Human Re- 
sources, Natural Resources and Community De- 
velopment and Transportation, together, shall 
furnish the Council with such staff as it reason- 



Section j_l^ This Executive Order shall become 
effective immediately and shall expire in accord- 
ance with North Carolina law two years from the 
date on which it is signed. This Executive Order 
is subject to reissuance or extension at the direc- 
tion of the Governor. 

Done in Raleigh, North Carolina, this 31st day 
of May, 1989. 



366 



NORTH CAROLINA REGISTER 



VOTING RIGHTS ACT FINAL DECISION LETTER 



[G.S. I20-30.9H, effective July 16, 1986, requires that all letters and other documents issued by the 
A ttomey General of the United States in which a final decision is made concerning a "change af- 
fecting voting" under Section 5 of the Voting Rights Act of J 965 be published in the North Carolina 
Register. / 



U.S. Department of Justice 
Civil Rights Division 

JPT:LLT:KIF:gmh 

DJ 166-012-3 Voting Section 

Y4634-4635 P.O. Box 66128 

Y69I5 Washington, D.C. 20035-6128 

June 12, 1989 

Richard J. Rose, Esq. 

Poyner & Spruill 

P.O. Box 10096 

Raleigh, North Carolina 27605-0096 

Dear Mr. Rose: 

This refers to the two annexations (Nos. 177 and 178, Ordinance Nos. 0-88-68 and 0-88-87) and 
the designation of the annexed areas to single -member districts for the City of Rocky Mount in 
Edgecombe and Nash Counties, North Carolina, submitted to the Attorney General pursuant to Sec- 
tion 5 of the Voting Rights Act of 1965, as amended, 42 L'.S.C. 1973c. We received your submission 
on April 11, 1989. 

The Attorney General does not interpose any objections to the changes in question. However, 
we feel a responsibility to point put that Section 5 of the Voting Rights Act expressly provides that the 
failure of the Attorney General to object does not bar any subsequent judicial action to enjoin the 
enforcement of such changes. See the Procedures for the Administration of Section 5 (28 C.F.R. 
51.41). 



Sincerely, 



James P. Turner 

Acting Assistant Attorney General 

Civil Rights Division 



By: 



Barry H. Weinberg 
Acting Chief, Voting Section 



NOR TH CAROLINA REGIS TER 367 



PROPOSED RULES 



TITLE 4 - DEPARTMENT OF COMMERCE 



No 



otice is hereby gh'en in accordance with G.S. 
1 508- 1 2 that the Commerce Finance Center in- 
tends to amend rulei s ) cited as 4 SCAC IJ .0101 
- .0/02. .0201, .0301; and adopt rulei s) cited as 
4 SCAC IJ .0401. 

1 he proposed effective date of this action is So- 
vember I, 1 989. ' 



Th 



he public hearing will be conducted at 10:00 
a.m. on August 2, 1989 at Room 6168 - Dobbs 
Building. 430 S. Salisbury Street, Raleigh. .\'C 
2~6II.^ 

(comment Procedures: .Any person interested in 
this rule may present oral comments to the action 
proposed at the public rule-making hearing or de- 
liver written comments to the Commerce Finance 
Center no later than .August 4, 1989. .Anyone 
planning to attend the hearing should notify Bruce 
Strickland. Jr., Commerce Finance Center, by 
August I, 1989. 

CHAPTER 1 - DEPARTMENTAL RLLES 

SLBCHAPTER IJ -NORTH CAROLINA JOBS 
TAX CREDIT 

SECTION .0100 - PURPOSE AND DEFINITIONS 

.0101 BACKGROLND AND OBJECTIVES 

G-S. 1115- 130.40 and G.S. 105-151.17, as 
amended. pro\ide Chaptor -^^ &f tfee 19>[ i 7 S«s- 
«eft Lq' i vu providoo that certain employers may 
be eligible for and may qualify' for a credit against 
the tax proposed by the North Carolina Depart- 
ment of Revenue. This credit of two thousand 
eight hundred dollars ($2,S00) may be claimed 
when qualifying fuU-time employees are added 
by an eligible employer in a severely distressed 
county. The legislation sets out particular re- 
sponsibilities for throo two separate departments 
of State Government; this Section is to set how 
the Department of Commerce will conduct ac- 
tivities and responsibilities assigned to it under 
this act. 

.Authority G.S. I05-I30.40(aj,ib),(c), and id); 
105-151'. rial. (b),(ci. and (d); Chapter 568, 
198^ S.L.; Chapter III. 1989 S.L. 

.0102 DEFINITIONS 

(a) "Distress factor": a distress factor is defmed 
as the sum of: 



(Ij the county's rank in a ranking of counties 

by rate of unemployment from lowest to 

highest, and 
(2) the county s rank in a ranking of counties 

by p>er capita income from highest to 

lowest. 

(b) "Date of sigiung" shall be defmed as the 
date on which the Secretan' of Commerce, his 
designee, or the Commerce Finance Center re- 
ceives and accepts as complete, a conmiitment 
under Paraaraph (d) of Gr^ 105 IJO. 1 G.S. 
105-130.40 ^d G.S. 105-151.17. Such a com- 
mitment will not be so defmed unless it is signed 
by a officer of the corporation or by the taxpayer. 

(c) "Department" means the North Carolina 
Department of Commerce. 

(d) "Eligible employer" is defmed as a corpo- 
ration that IS located in A« a distressed county, 
tfe** engag e s jfir »f ffea* i* a taxpayor Aa* ov i ns » 
buoinasG rtta* ongag e s h*t manufacturing, 
agribuoinoC ' O. procoooion. warohouomg, rotailing, 
r e c i eorch aR4 do' i olopmont ef » service related ift- 
dustry. a* determm 'e4 bv ti*e North Corolina 
Employment S e cunty CommiL ' Sion. 

(e) "EuU tune employee" is detlned as an em- 
ployee who holds a full time job. 

(f) "FuU time job" is defmed as a position that 
is located m the distressed county and requires 
at least 1600 hours of work per year and is in- 
tended to be held by one person durmg the entire 
year. 

(g) "Letter of Commitment" is detlned as an 
agreement between the department and a corpo- 
ration or a ta.xpayer. tbat- »t 

(-4-f dotormirn ?4 a^ oUgiblo fef tfe» credit b^ t^ 

Employment Soounty Commior . ion. »f 
(5^ if a formal dotormination kas ftet boon 
made by tk« Employment Security Com 
mission, that- l»e rocei' i od a ad' i isoryr 
opmion y^ tiiat effect from A#t- agency "s 
chief counsel. 
This letter of commitment wiU set out: 

(l)fA^ the name of the corporation or the 
individual ta.xpayer entity that wiU tile the 
North Carohna tax return under Chapter 
105: 

(2)fB->' the name that will be used in the 
conduct of business, if different from: 

(3)f^ the permanent or Home Office address 
of the management group directing the 
operation of the business; 

(4)<-E4 the location(s) of the qualif)'ing busi- 
ness operations withm the distressed 
county; 

f5')ffei a schedule showing the number of 
permanent full time positions to be cre- 
ated and the tune sequence for their beine 
filled; 



36S 



\ORTH C.AROLIS.i REGISTER 



PROPOSED RULES 



(6')fP4 an estimate of the cost of new capital 
expenditures within the distressed county 
over the two year time period of the 
commitment; 

(7)fG> an official contact with the operating 
firm to whom inquiries pertinent to the 
agreement can be directed; 
fW) Ae firm's otatomont regarding awaronoso 
ef aft4 accoptonco %i proooduroG relating 
to \^ program being requir e d hf tiw 
North Carolina Employmont Security 
CommioGion, e opeoially as r e gards te tfe» 
filing ef quarterly wage r e ports, 

(8)fl^ the date of signing, as defined in Para- 
graph (b) of this Rule; 

(9)(fe^ where the scope of a project changes 
significantly after the Letter of Commit- 
ment has been filed, and within the same 
calendar year, a corporation or individual 
taxpayer may then file a new letter of 
commitment in that year which shows re- 
vised data; 
(10) f»> "severely distressed county" is defmed 
as a county designated as such by the 
Secretary of the Department of Com- 
merce. The secretary will make such a 
designation only if a county has a dis- 
tressed factor that is one of the 20 highest 
in the state. a«4 it- ba* ai* unemployment 
Fate e4 oo' i 'on percent »f more. 

Authority G.S. I05-I30.40(c) and (d); 
105-151. 17(c) and (d); Chapter 568, 1987 S.L.; 
Chapter III. 1989 S.L. 

SECTION .0200 - DESIGNATION OF SEVERELY 
DISTRESSED COUNTIES 

.0201 DESIGNATION OF SEVERELY 
DISTRESSED COUNTIES 

On or before December 31 of each calendar 
year, the secretary of the department shall desig- 
nate which counties are considered as severely 
distressed, and shall provide that information to 
the Secretary of Revenue. The department will 
obtain from the North Carolina Employment 
Security Commission the adjusted monthly esti- 
mates of unemployment for the most recent 36 
month period for which data is available. Those 
monthly estimates will be averaged and those 
averages used to rank the counties by arranging 
them in numerical order of the county with the 
lowest unemployment as number 1 to the county 
with the highest unemployment as number 100. 

The department will obtain from the United 
States Department of Commerce the latest avail- 
able annual per capita income figures, by county, 
for the most recent 36 month percent for which 



data is available. Those annual figures will be 
averaged and those averages used to rank the 
counties in numerical order of the county with 
the highest per capita income average as number 
1 to the county with the lowest per capita income 
average as number 100. These two rankings will 
be totaled so as to provide a sum which will be 
the county's distress factor. Those 20 counties 
with the highest distress factors will be designated 
as severely distressed by the Secretary of Com- 
merce, enumerated. That list ©f i^ countioij wili 
b© compared to tfe* adjusted unemployment fig- 

dato obtained from tfe» Employm e nt Security 
Commiaoion. Where that county unemployment 
Fat« fef tfeat latest month is so^'on p e rc e nt ef 
more, A* s e cret ary V¥ili d e signate the county as 
sev'eroly distressed, documenting that: 

f4^ ft county has a distress factors s' l 'hich is mm 
Bi^f» 20 highest m tk« state, aH4 

(3) a county has aa unemployment Fato ef 
se¥e» percent ef more. 
The list of counties so designated will be pro- 
vided to the Secretary of the North Carolina 
Department of Revenue. In addition, written 
notice of that designation will be given to the 
chairman of elected governing board in each 
county so designated. 

Authority G.S. I05-I30.40(c) and (d): 
105-151. 17(c) and (d); Chapter 568. 1987 S.L.; 
Chapter III. 1989 S.L. 

SECTION .0300 - LETTER OF COMMITMENT 

.0301 LETTER OF COMMITMENT 

"Letter of Commitment" will be made in the 
form prescribed by the Department of Com- 
merce. They will complete as defmed in Rule 
.0102 (g) of this Section. When accepted and 
signed by the secretary, or his designee, that ac- 
ceptance will be given in writing to the person(s) 
or entity offering the commitment. These com- 
mitments will be received and will be kept on 
record at the Commerce Finance Center, Room 
2174, OOWt Dobbs Building, 430 N. Salisbury 
Street, Raleigh, North Carolina 27611. A sum- 
mary listing of those commitments made avail- 
able to the Department of Revenue within 90 
days after the close of each calendar year. 

Authority G.S. I05-I30.40(c) and (d): 
105-151. 17(c) and (d); Chapter 568. 1987 S.L. 

SECTION .0400 -SLBST.\NTIATION OF 
CREDIT CLAIMED 

.0401 SUBSTANTIATION OF CREDIT 
CLAIMED 



NORTH CAROLINA REGISTER 



369 



PROPOSED RULES 



Even' taxpayer claiming the Jobs Tax Credit 

shall maintain and make available for inspection 
by the Secretary of Revenue such records as may 
be necessary to determine and verify the amount 
of credit to which the taxpayer is entitled. The 
burden of proving ehgibility for the credit and the 
amount of the credit rests with the taxpayer, and 
no credit will be allowed to the taxpayer who fails 
to maintain adequate records or to make them 
available for inspection. 

Authoritv G.S. I05-I30.40(f); 105-151 .17(f): 
Chapter III. 1989 S.L. 

TITLE 7 - DEPARTMENT OF CLLTTRAL 
RESOURCES 



l\ otice is hereby given in accordance with G.S. 
I50B-I2 that the Cultural Resources: Archives and 
History intends to adopt and amend rulefsj cited 
as 7 NCAC4S .0001 - .0010. 

1 he proposed effective date of this action is So- 
vember I. 19,39. 

1 he public hearing will be conducted at 9:30 
a.m. on August S. 1989 at Archives and History- 
State Library Building, 109 E. Jones Street, Room 
305. Raleigh. SC. 



Co 



omment Procedures: Written comments to 
Dr. William S. Price, Jr.. Director, Division of 
.Archives and History, 109 E. Jones Street. 
Raleigh. SC 2'^6II (Room 305) no later than 
5:00 p.m.. August 7, 1 989. 

CHAPTER 4 - ARCHIVES AND HISTORY 
SLBCH AFTER 4S - TRYON PALACE SECTION 

.0001 STATEMENT OF PURPOSE 

The purpose of the Tryon Palace Section is to 
preserve, operate, and maintain the Tryon Palace 
Complex Restoration for public benefit, to pres- 
ent a program whereby citizens have maximum 
opportunity to learn and appreciate their history 
and heritage as represented through the exhibi- 
tion facilities, and to maintain the collections in 
keeping with the best conservation practices. It 
is also the section's purpose to increase visitation 
through wider promotion and pubhcity and 
through expanded crafts programs and special 
educational tours. 



.0002 VISITING HOLRS 

(a) Trv'on Palace Restoration will be open 
TuoDday .Mondav through Saturday from 9:30 
a.m. to 4:00 p.m. and on Sunday from 1:30 p.m. 
to 4:00 p.m. 

(b) Tryon Palace Restoration will be closed on 
Monday (except fof Eaotor .Monday smd Labor 
Day), New "\'ear's Day, Thanksgiving Day, and 
Christmas holidays as set by the State of North 
Carolina for state employees. 



Statutory Authority G.S. 
1 433-71. 



121-14: 121-20: 



.0003 ADMISSION PRICES 

Admission prices are: 

f4-^ Tryon Palace aR4 gardens, adults, fo«f 
doUaro (Sl.OO): studl ' nto through \w^ 
school. ©«» doUar (Sl.OO): ooUego students 
aH4 military porconnol vritfe id e ntification, 
thr ee doUars (tJ.OQ): senior citigeno groups 
aH4 commercial b«* tours arrangod i» a4- 
vonoe. throe doUars (SJ.OO). 

f3> Stanly House, adults, tv,^ dollars ($2.00); 
students throuah high school, e+n* doUar 
($1.00). 

(4) Stevenson House, adults, ^¥e■ dollars 
($2.00): students throuah kt«fe school, »«« 
detiaf ($1.00). 

(-4^ General admission ticket te aU exhibition 
buildings aft4 gardens, adults, i5«t dollars 
($6.00); students through high school, twe 
dollars ($2.00). 

(4^ Garden ticket, adults. Vwe doUaro ($2.00); 
students throuah h«ik school, eft« dollar 
($1.00). 

(4^ T»^ charge fef children und e r swtr 

(1) Trvon Place and gardens, adults eight dol- 
lars ($8.00); students through high school, 
four doUars (S4.00): college students and 
militarv personnel with identification, seven 
doUars ($7.00); groups of 20 or more ar- 
ranged in advance, seven doUars ($7.00). 

(2) Stanlv and Dixon-Stevenson Houses, 
adults, eight doUars ($8.00); students 
through high school, four doUars ($4.00). 

(3) General admission ticket to all exhibition 
buUdings and gardens, adults, twelve doUars 
($12.00); students through high school, six 
doUars ($6.00). 

(4) Garden ticket, aduhs, four doUars ($4.00): 
students through high school, three doUars 
($3.00). 

(5) No charge for chUdren under six. 



Statutory- 
I43B-7I. 



Authoritv G.S. 121-14: 121-20: 



Statutory Authority G.S. 
I43B-7I'. 



121-14: 121-20: 



370 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



.0004 VISITATION RULES 

(a) Eating and chewing gum are not permitted 
in the Tryon Palace Restoration exhibition 
buildings. With prior approval of the Chief, 
Tnon Palace Section, refreshments may be 
served within the exhibition area for special 
events and meetings. 

(b) Pets are not permitted in the buildings or 
on the grounds of the complox. restoration, ex- 
cept guide dogs for legaily blind persons. 

(c) Photography is permitted inside the exhibi- 
tion buildings with advance approval of the 
Chief, Tr>on Palace Section. A staff member 
must accompany the photographer at all times. 
Requirements for special lighting or wiring must 
be cleared through the plant maintononco oupor 
visor, technical services director. 

(g) All tours of the Tr\'on Palace exhibition 
buildings are conducted by hootooooo. guides. 
The general public is not allowed to go through 
the buildings without a hoiitooD. guide. 



Statutory Authority 
1438-62(2 Id. 



G.S. 1 21 -4(8), (9): 



.0005 LSE OF THE ALDITORILM 

(b) Application for use must be presented to 
and approved by the Chief, Trvon Palace Sec- 
tion, according to the following regulations: 
(5) .Microphones and any state-owned audi- 
ovisual equipment must be operated by a 
member of the Tryon Palace Restoration 
staff. 



Statutory A uthority 
143B-62(2)d. 



G.S. 121-4(8), (9); 



.0006 RESEARCH 

With special written p>ermission of the Chief, 
Tr\on Palace Section, research may be con- 
ducted by qualified scholars or persons in the 
museum field utilizing items in the libraries and 
collections of the Tryon Palace complox Resto- 
ration during regular hours of operation. 



Statutory Authority 
I43B-62(2)d. 



G.S. I2l-4(8),(9): 



.0007 AUDIOVISUAL AIDS 

Slide sets of Tryon Palace are available on a 
loan basis for a small fee through the education 
branch of the Tryon Palace Section. The fee for 
use of the -34- slide set with script is two dollars 
($2.00) plus return postage by insured mail. 



Statutory Authority 
l43B-62(2)d. 



G.S. I2I-4(8),(9),(I4); 



.0008 PHOTOGRAPHIC SERVICES 

Photographs from the Tr>on Palace 
accessioning files are available at cost. Special 
photos can be taken by a member of the Tryon 
Palace staff on special order at cost. Inquiries 
should be addressed to the Rogictrar. Director 
of Research and Collections. 

Statutory Authority G.S. 121-14; 121-20; 
1 433-71. 

.0009 ACQUISITION OF ARTIFACTS 

Furniture, art objects, artifacts, or other objects 
within the period of the Tryon Palace complox 
Restoration buildings are accepted on behalf of 
the state by the Tryon Palace Commission to 
further interpret the history and life styles of the 
appropriate periods. Offers of gifts or loans of 
furniture, art objects, and artifacts to Tryon Pal- 
ace must be directed to the Choirmaft r Tr^on 
Polaco Commiooion. Chief, Trvon Palace Sec- 
tion. The Chairmoft chief will »fef present all 
such offers to the appropriato committoo ef the 
Tp/on Palace Commiooion fof Chairman of the 
Tryon Palace Commission with a recommenda- 
tion of which artifacts shall be accepted. The 
chairman wiU refer the recommendation to the 
appropriate committee of the Trvon Palace 
Commission. 



Statutory Authority 
l43B-62(2)d. 



G.S. 



I2I-4(S),(9); 



.0010 OPERATION 

Rules .0102 through .0108 in Subchapter 4N, 
Section .0100, shall apply to the operation of the 
Tr>on Palace Restoration. 



Statutory Authority 
l43B-62(2)d. 



G.S. 121-4(8), (9); 



****************** 



IS otice is hereby given in accordance with G.S. 
I SOB- 1 2 that the Cultural Resources/ Division of 
the Arts Council intends to adopt rule(s) cited as 
7 NCAC 12 .000 1 -.0005. 

1 he proposed effective date of this action is No- 
vember I, 1989. 

1 he public hearing will be conducted at 9:00 
a.m. on August 2, 1989 at Room 315, Archives 
and History Bldg., 109 E. Jones Street, Raleigh, 
N. C. 



NORTH CAROLINA REGISTER 



371 



PROPOSED RULES 



Co 



omment Procedures: Written comments may 
be submitted by July 31, 1989. to the APA Coor- 
dinator for the Department of Cultural Resources, 
Dr. Bovd Cathey, Room 308, Archives and His- 
tory Bl'dg., 109 E. Jones Street, Raleigh, AC. 

CHAPTER 12 - ART WORKS IN STATE 
BLILDINGS PROGRAM 

.0001 CONSTRLCTION REVIEW 

The Department of Administration shall review 
authorized construction projects with the North 
Carolina .\rts Council and insure that amounts 
expended for acquisition of art works are in- 
cluded in construction requests from state agen- 
cies. 

Statutory Authority G.S. 143-408.4; 143-408.5. 

.0002 TR.VNSFER OF FLNDS 

The OtTice of State Budget and Management 
will approve the transfer of all funds determined 
appropriate for the acquisition of art from the 
appropriate capital improvement code to the 
Department of Cultural Resources. 

Statutory Authority G.S. 143-408.4. 

.0003 PROGRAM ADMIMSTR.\TION 

The Department of Cultural Resources, 
through the North Carolina Arts Council, shall 
establish a single administrative fund for the Art 
Works in State Buildings Program. No more 
than 8 percent of available program funds may 
be applied to the administration of the program. 
The North Carolina .Arts Council may supple- 
ment funding for program administration. 

Statutory Authority G.S. J 43-408.4. 

.0004 GLIDELINES 

Guidelines, mcludlng assurances of the involve- 
ment of disadvantaged and minority artists, will 
be established and publicized by the North 
Carolina Arts Council. 

Statutory Authority G.S. 143-408.4. 

.0005 SELECTION, INSTALLATION, AND 
MAINTENANCE 

The North Carolina .Arts Council has the re- 
sponsibility to: 

(1) coordinate the input and involvement of 
the owning agency in the selection process; 

(2) submit for approval to the .Art Works in 
State Buildings committee the project artist 
selection plan; 



(3) advertise the need for artist services in the 
North Carolina Purchase Directory; 

(4) appoint a pre-selection committee com- 
prised of a minimum of three arts profes- 
sionals, directed by the Public Art 
Administrator, to recruit and screen artists 
of exceptional merit; 

(5) submit for approval to the Art Works in 
State Buildings committee the artist(s) re- 
commended through the approved plan; 

(6) contract with artist{s) and oversee the 
completion of commissioned art work(s); 

(7) coordinate with the Department of Ad- 
ministration, the owning agency and the de- 
signer to arrange for installation of work(s) 
of art; 

(8) own all works of art acquired under this 
act and maintain records of the art works; 

(9) provide condition reports on art works and 
request funds as necessar>' for the on-going 
maintenance of the arts works; and 

(10) provide the owning agency with a letter 
of agreement which specifies routme allow- 
able maintenance procedures. 

Statutory Authority G.S. 143-408.4; 143-408.5. 



TITLE 10 



DEPARTMENT OF HL^NlAN 
RESOURCES 



No 



otice is hereby given in accordance with G.S. 
1 508- 1 2 that the Sorth Carolina Department of 
Human Resources intends to repeal rule(s) cited 
as 10 SCAC IB .0401 - .0417; and adopt rule(sj 
cited as 10 SCAC IB .0418 - .0419. 

I he proposed effective date of this action is \o- 
vember I. 1989. 

1 he public hearing will be conducted at 9:00 
a.m. on August 14, 1989 at Room 158, Adams 
Bldg., 101 Blair Drive, Raleigh, XC . 



U603. 



Co 



omment Procedures: Written comments con- 
cerning the adoption of these rules and the repeal 
of these rules must be submitted to Steven P. 
Rader, Assistant Director of Legal AJfairs, DHR. 
101 Blair Drive, Raleigh. SC 27603. Oral com- 
ments may be presented at the hearing. In addi- 
tion, fiscal impact statements on this adoption and 
repeal of these rules are available upon written 
request from the same address. 

CHAPTER 1 - DEPARTMENTAL RULES 

SLBCHAPTER IB - PROCEDURE 



372 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



SECTION .0400 - ALDITING PROCEDURES 

.0401 AUDITING STANDARDS AND SCOPE 

OF AUDIT (REPEALED) 
.0402 NOTIFICATION OF AUDIT 

(REPEALED) 
.0403 DISCUSSION OF SCOPE OF AUDIT 

(REPEALED) 
.0404 COMPLETION OF AUDIT FIELDWORK 

(REPEALED) 
.0405 PRE-EXIT CONFERENCE 

(REPEALED) 
.0406 NOTIFICATION OF TENTATIVE 

FINDINGS (REPEALED) 
.0407 FURTHER REVIEW OF AUDIT TO 

MAKE REPORT FORMAL (REPEALED) 
.0408 EXIT CONFERENCE TO BE 

SCHEDULED (REPEALED) 
.0409 DISTRIBUTION OF AUDIT REPORTS 

(REPEALED) 
.0410 WRITTEN RESPONSE TO FORMAL 

AUDIT (REPEALED) 
.0411 DIVISION DIRECTOR REVIEWS 

RESPONSE AND MAKES 

RECOMMENDATION (REPEALED) 
.0412 SECRETARY ESTABLISHES FINAL 

POSITION (REPEALED) 
.0413 GRANTEE OR PROVIDER RESPONDS 

TO DEPARTMENTAL DECISION 

(REPEALED) 
.0414 APPOINTMENT OF AUDIT REVIEW 

COMMITTEE (REPEALED) 
.0415 PROCEDURES APPLICABLE TO 

HEARING (REPEALED) 
.0416 RESOLUTION OF AUDIT (REPEALED) 
.0417 AUDITING PROCEDURES/AUDITS 

PERFORMED/EXTERNAL AUDITORS 

(REPEALED) 



Statutory 
I43B-139.I. 



.0418 



Authority G.S. I43B-I0(j): 



SINGLE AUDITS OF LOCAL 
GOVERNMENTS AND PUBLIC 
AUTHORITIES 

(a) Independent auditors retained to conduct 
single audits for local governments or public au- 
thorities may be notified by the Department of 
Human Resources (Department) or the Local 
Government Commission of problem areas that 
the audit should address. 

(b) The Local Government Commission has 
the responsibility of reviewing single audits for 
compliance with 0MB Circular A- 128 and ac- 
cepting those single audits for the state that have 
been determined to comply with federal and state 
requirements. Whenever a single audit is per- 
formed on a local government or public authority 
that received funds from the Department during 
the fiscal year audited, the Local Government 
Commission shall provide the Department with 
a copy of the audit report(s). 



(c) Upon receipt of the audit report from the 
Local (jovemment Commission, the Depart- 
ment shall send a letter to the local government 
or public authority requesting the submission of 
a corrective action plan which addresses each 
finding and recommendation contained in the 
auditor's report(s) on compliance and internal 
control and schedule of questioned cost. The 
corrective action plan shall include the following 
information: 

(1) Specific concurrence or non-concurrence 
with each fmding, recommendation, or 
questioned cost; 

(2) If the local government or public authority 
agrees with a finding, recommendation or 
questioned cost, a description of the spe- 
cific corrective actions taken or planned, 
including time schedules, to settle the 
finding or implement the recommenda- 
tion; and 

(3) If the local government or public authority 
disagrees with a fmding, recommendation 
or questioned cost, the specific reason(s) 
and legal or regulatory basis for the disa- 
greement. 

The local government or public authority shall 
submit the corrective action plan to the Con- 
troller of the Department within 30 days after 
receipt of the request. 

(d) FoUowing receipt of the corrective action 
plan by the Department, relevant portions of the 
audit report(s) and corrective action plan shall 
be sent to the chief fiscal officer of each division 
responsible for administration of the programs 
affected for coordination of a Division position 
on the corrective actions planned or taken. 

(e) The Department or any affected division 
of the Department may request any additional 
information deemed necessary for clarification of 
an audit fmding, recommendation, questioned 
cost or the corrective action plan. The local 
government or public authority shall provide the 
information to the requesting official within 30 
days after the receipt of the request. If additional 
information or clarification from the independent 
auditor is requested, the local government or 
public authority shall direct its auditor to provide 
the infoimation requested to the requesting offi- 
cial within the 30 day response time. 

(0 If the chief fiscal officer of an affected divi- 
sion has reason to believe that due professional 
care was not used in conducting a single audit or 
if a local government or public authority or their 
independent auditor is unwilling or unable to 
provide clarification or additional information 
requested by an official of the Department, a 
written request for review of the auditor's work 
papers may be filed with the Controller of the 



NORTH CAROLINA REGISTER 



373 



PROPOSED RULES 



Department. The ControUer shall make or ar- 
range for any review of the auditor's work papers 
deemed necessary for timely resolution of single 
audit fmdings, recommendations, or questioned 
cost. 

(g) FoUowing receipt of any additional infor- 
mation requested, the chief fiscal officer of an af- 
fected division shall prepare a recommendation 
to accept or reject the corrective action plan for 
each fiscal compliance fmding, recommendation 
or questioned cost. The Director of an affected 
division shall prepare a recommendation to ac- 
cept or reject the corrective action plan for each 
program- specific comphance fmding or recom- 
mendation. If the corrective action plan is re- 
jected, the reasons for the rejection and an 
acceptable corrective action will be specified. 
These recommendations will be forwarded to the 
Controller of the Department for coordination 
of a Departmental position on the corrective 
action plan. 

(h) The Secretary of the Department shall 
provide the local government or public authority 
with a written determination which accepts or 
rejects the corrective action plan for each audit 
fmding, recommendation or questioned cost that 
pertains to or otherwise affects a program(s) of 
the Department. If the corrective action plan is 
rejected the reasons for the rejection and an ac- 
ceptable corrective action will be specified in the 
determination letter. If the corrective action plan 
indicates that the proposed corrective action for 
nonmonetary fmdings has not been imple- 
mented, the determination on all nonmonetary 
findings shall specify the time by which the local 
government or public authority shall implement 
the corrective action if different from the time 
proposed in the corrective action plan. The de- 
termination on all questioned costs or other 
charges to the Department shall state whether the 
cost or other charge is allowable or unallowable 
for reimbursement to the local government or 
public authority under applicable laws and regu- 
lations. If a cost or other charge to the Depart- 
ment is determined to be unallowable for 
reimbursement, the determination letter shall re- 
quire full monetary repayment to the Depart- 
ment within 60 days of the date of the 
determination letter. The amount of any cost 
or other charge determined to be unallowable 
shall constitute a debt due the State of North 
Carolina until repayment in fuU is received by the 
Department. 

(i) A determination by the Secretary of the 
Department required under Paragraph (h) of this 
Rule shall become fmal unless timely notice of 
appeal is filed in accordance with G.S. 150B-23. 



(j) Upon timely notice of appeal filed in ac- 
cordance with G.S. I50B-23 monetary repay- 
ment or implementation of a corrective action 
required under Paragraph (h) of this Rule wiU 
be suspended only for individual determinations 
or parts of a determination specifically disputed 
in the apf)eal. Interest may be charged under the 
conditions specified under Paragraph (k) of this 
Rule on the amount of any cost or other charge 
determined to be unaUowable under Paragraph 
(h) of this Rule. 

(k) Except where otherwise provided by stat- 
utes or regulations, Federal agencies are required 
to charge interest on overdue amounts in ac- 
cordance with the Federal Claims Collection 
Standards (4 CFR Ch. II). The date from which 
interest is computed is not extended by litigation 
or the filing of any form of appeal. If a Federal 
agency charges the Department interest on the 
Federal share of an overdue amount from a local 
government or public authority, the Department 
shall charge the interest to the local government 
or public authority. 

(1) If a local government or public authority 
fails to make repayment of an amount due to the 
Department or obtain Department approval of a 
deferred payment plan by the "due date" speci- 
fied in Paragraph (h) of this Rule the Department 
shall offset the amount of the disallowance or any 
portion thereof remaining unpaid and any inter- 
est due from subsequent reimbursements or other 
amounts due the local government or public au- 
thority until the amount due is fuUy recovered. 

(m) A local government or public authority 
may propose a plan for repayment of amounts 
determined to be unallowable on an installment 
basis. TTie local govenunent or public authority 
must certify that it is unable to make repayment 
by the "due date" specified in Paragraph (h) of 
this Rule and that commercial fmancing can not 
be obtained. Repayment of the federal share of 
amounts determined to be unallowable will not 
be allowed on an installment basis unless the 
Federal grantor agency approves of the install- 
ment plan or otherwise allows the Department 
the same installment repayment terms. Interest 
may be charged as specified under Paragraph (k) 
of this Rule while awaiting Federal approval of 
an installment plan or on installment payments. 

(n) If a local government or public authority 
fails to submit the corrective action plan required 
under Pa' japh (c) of this Rule or additional 
informar requested under Paragraph (e) of this 
Rule or .is to implement corrective action 
within 1 J iimeframe established by the Secretary 
under P;iragraph (h) of this Rule, the Secretary 
of the Department or the Director of the re- 
questing Division may suspend all or any portion 



374 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



of the administrative and indirect cost funding 
administered by the Department until such time 
as the required corrective action plan or addi- 
tional information is submitted as requested. 
Alternatively, the Secretary of the Department 
may issue a unilateral determination on the audit 
fmdings, recommendations, and questioned cost 
requiring any corrective action and repayment of 
questioned cost deemed necessary for compliance 
with the laws and regulations governing assist- 
ance programs affected. 

Statutory Authority G.S. I43B-I0(j); 
143B-I39.I; ! 43 B- 139.3; 159-34. 

.0419 AUDITS OF HOSPIT.ALS, 

NONPROFITS, HIGHER EDUCATION 
AGENCIES 

(a) Public and private hospitals, public and 
private institutions of higher education and 
quasi-pubhc and private nonprofit organizations 
(recipient orgaruzation(s)) which receive state 
and/or federal funds of twenty-five thousand 
dollars ($25,000) or more from the Department 
of Human Resources (Department) in the form 
of grants, cost reimbursement contracts or other 
forms of financial assistance agreements shall 
have an audit made as a condition of receipt of 
funds for each fiscal year of the recipient organ- 
ization in which fmancial assistance funds are re- 
ceived. The audit shall be performed in 
accordance with OMB Circular A- 1 10, Attach- 
ment F.2.h. until OMB Circular A- 133 is issued. 
After issuance of OMB Circular A- 133, audits 
shall be performed in accordance with the pro- 
visions of that Circular. 

(b) The University of North Carolina and 
public hospitals operated by the State of North 
Carolina have armual audits performed by the 
State Auditor. The scope of such audits and the 
contents of the audit reports are the responsibility 
of the State Auditor and shall be accepted and 
relied upon by the Department unless a cogni- 
zant Federal agency finds that such audits do not 
meet the requirements of OMB Circular A- 110, 
A- 133 after issuance, or A- 128. 

(c) The above audit requirements are not ap- 
plicable to procurements. However, the purpose 
and substance of an agreement rather than form 
shall govern whether financial assistance was 
provided. A subrecipient is an entity that re- 
ceives fmancial assistance passed down from the 
prime recipient. The subrecipient's responsibility 
is to help the recipient meet the requirements of 
the assistance award. The test for a subrecipient 
relationship is whether fmancial assistance is re- 
ceived from a recipient to carry out a program. 
A vendor is an entity that receives a procurement 



contract for goods or services. The vendor's re- 
sponsibihty is to meet the requirements of the 
procurement contract. 

(d) The above audit requirements are not in- 
tended to replace a request for submission of au- 
dit reports in connection with requests for direct 
appropriation of State Aid by the General As- 
sembly through the Secretary of the Department 
for recommendations to the Govemor and the 
Advisory Budget Conmiission and the General 
Assembly in accordance with G.S. 159-34. 

(e) The above audit requirements are not in- 
tended to replace requirements for submission of 
a fmancial audit report or fmancial information 
by the Department in connection with applica- 
tions for funding or licensure, provider certif- 
ication or cost reporting, and other purposes not 
related to provision of State and Federal fmancial 
assistance. 

(f) The Secretary of the Department may grant 
a waiver of any or all of the audit standards to a 
recipient organization who does not receive any 
grants, contracts or other fmancial assistance fi- 
nanced in whole or in part with Federal funds 
when an audit of assistance fmanced with State 
funds is not otherwise required by law and is not 
cost effective. 

(g) Each recipient organization shall be re- 
quired to submit one copy of the audit report and 
corrective action plan required in Paragraph (a) 
of this Rule to each division of the Department 
which provided State and/or Federal fmancial 
assistance during the fiscal year covered by such 
audit within 30 days from the date the report is 
issued by the auditor, and no later than the 13th 
month following the close of the recipient or- 
ganization's fiscal year in which assistance was 
received. 

(h) Upon receipt of the audit report the De- 
partment shall conduct a desk review of the audit 
report to determine if the rep>orting standards re- 
quired in OMB Circular A-110 or A-133 when 
it is issued have been met. If an audit received 
from a recipient organization does not meet the 
standards required in OMB Circular A-110 or 
A-133 when it is issued, the Secretary of the De- 
partment shall issue a letter of determination to 
the recipient organization rejecting the audit and 
listing the required standards that were not met. 
The recipient organization shall be allowed no 
more than 90 days from the date of receipt of the 
Secretary's determination letter to submit a re- 
vised audit report which meets the standards re- 
quired in OMB Circular A-110 or A-133 when 
it is issued. If the recipient organization fails to 
submit an audit report revised in accordance with 
the determination letter, the Secretary may sus- 
pend further financial assistance payments to the 



NORTH CAROLINA REGISTER 



375 



PROPOSED RULES 



recipient organization and/or subject the recipi- 
ent organization to an audit or compliance re- 
view by the Department or the State Auditor. 

(i) TTie Department or any affected division of 
the Department may request any additional m- 
formation deemed necessary for clarification of 
an audit finding, recommendation, questioned 
cost or the corrective action plan. The recipient 
organization shall provide the information to the 
requesting official within 30 days after the receipt 
of the request. If additional information or clar- 
ification from the independent auditor is re- 
quested, the recipient organization shall direct 
their auditor to provide the information re- 
quested to the requesting official. 

(j) If the Department has reason to believe that 
due professional care was not used in conducting 
the audit required under 0MB Circular A- 110 
or A- 133 when it is issued, or if the recipient or- 
ganization or their auditor is unwilling or unable 
to provide clarification or additional information 
requested by an official of the Department, the 
Controller of the Department may make or ar- 
range for any review of the auditor's work papers 
deemed necessary for timely resolution of the 
audit fmdings, recommendations, or questioned 
cost. 

(k) The Secretar}' of the Department shall 
provide the recipient organization with a written 
determination which accepts or rejects the cor- 
rective action plan for each audit fmding, recom- 
mendation or questioned cost that pertains to or 
otherwise affects a program(s) of the Depart- 
ment. If the corrective action plan is rejected the 
reasons for the rejection and an acceptable cor- 
rective action will be specified in the determi- 
nation letter. If the corrective action plan 
indicates that the proposed corrective action for 
nonmonetary fmdings has not been imple- 
mented, the determination on all nonmonetary 
findings shall specify the time by which the local 
government or public authority shall implement 
the corrective action if different from the time 
proposed in the corrective action plan. The de- 
termination on all questioned cost or other 
charges to the Department shall state whether the 
cost or other charge is allowable or unallowable 
for reimbursement to the recipient organization 
under applicable laws, regulations and other 
provisions of assistance agreements. If a cost or 
other charge to the Department is determined to 
be unallowable for reimbursement, the determi- 
nation letter shall require full monetary repay- 
ment to the Department within 60 days of the 
date of the determination letter. The amount of 
any cost or other charge determined to be unal- 
lowable shall constitute a debt due the State of 



North Carolina until repayment in full is received 
by the Department. 

(1) A determination by the Secretary of the 
Department required under Paragraph (k) or 
Paragraph (h) of this Rule shall become fmal 
unless timely notice of appeal is filed in accord- 
ance with G.S. 150B-23. 

(m) Upon timely notice of appeal fded in ac- 
cordance with G.S. 1508-23 monetary repay- 
ment or implementation of a corrective action 
required under Paragraph (k) of this Rule will be 
suspended only for mdividual determinations or 
parts of a determination specifically disputed in 
the appeal. Interest may be charged under the 
conditions specified under Paragraph (n) of this 
Rule on the amount of any cost or other charge 
determined to be unallowable under Paragraph 
(k) of this Rule. 

(n) Except where otherwise provided by stat- 
utes or regulations. Federal agencies are required 
to charge interest on overdue amounts in ac- 
cordance with the Federal Claims Collection 
Standards (4 CFR Ch. 11). The date from which 
interest is computed is not extended by litigation 
or the fding of any form of appeal. If a Federal 
agency charges the Department interest on the 
Federal share of an overdue amount from a re- 
cipient organization, the Department shall charge 
the interest to the recipient organization. 

(o) If a recipient organization fails to make re- 
payment of an amount due to the Department 
or obtain Department approval of a deferred 
payment plan by the "due date" specified in 
Paragraph (k) of this Rule the Department shall 
offset the amount of the disallowance or any 
portion thereof remaining unpaid and any inter- 
est due from subsequent reimbursements or other 
amounts due the recipient organization until the 
amount due is fully recovered. 

(p) A recipient organization may propose a 
plan for repayment of amounts determined to be 
unallowable on an installment basis. The recip- 
ient organization must certify that it is unable to 
make repayment by the "due date" specified in 
Paragraph (k) of this Rule and that commercial 
fmancing can not be obtained. Repayment of 
the federal share of amounts determined to be 
unallowable will not be allowed on an install- 
ment basis unless the Federal grantor agency ap- 
proves of the installment plan or otherwise 
allows the Department the same installment re- 
payment terms. Interest may be charged as 
specified under Paragraph (n) of this Rule while 
awaiting Federal approval of an installment plan 
or on installment payments. 

(q) If a recipient organization fails to submit 
the corrective action plan required under Para- 
graph (a) of this Rule or additional information 



376 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



requested under Paragraph (i) of this Rule or fails 
to implement corrective action within the 
timeframe established by the Secretary under 
Paragraph (k) of this Rule, the Secretary of the 
Department or the Director of the requesting 
Division may suspend payment to the recipient 
organization of all or any portion of the admin- 
istrative and indirect cost funding administered 
by the Department until such time as the re- 
quired audit, corrective action plan or additional 
information is submitted as requested. Alterna- 
tively, the Secretary of the Department may issue 
a unilateral determination on the audit fmdings, 
recommendations, and questioned cost requiring 
any corrective action and repayment of ques- 
tioned cost deemed necessary for compliance 
with the laws and regulations governing assist- 
ance programs affected. 



Statutory 
I43B-I39.I. 



Authority G.S. I43B-I0(j); 



■A-***************** 



No 



otice is hereby given in accordance with G.S. 
I SOB- 1 2 that the Division of Facility Services in- 
tends to repeal rule(s) cited as 10 S'CAC 3D 
.0101 - .OlOS. .0110 -.0115. .0201 - .0203. .0301 - 
.0302, .0401 - .0412, .0501 - .05/6. .0601 - .0608, 
.06/0 - .06/6. .070/; and adopt rule(s) cited as 
/O NCAC 3D .080/ - .08/6. .090/ - .0926, ./OO/ 
- ./004. .//O/ - .//04, .120/. ./30/, ./40/ - ./406, 
./SO/ - ./502, ./60/ - ./603. 

1 he proposed effective date of this action is De- 
cember /. /989. 

1 he public hearing will be conducted at 9:30 
a.m. on September /5. /989 at Division of Facility 
Services, 701 Barbour Drive, Room 20/, Raleigh, 
North Carolina 27603. 



Cc 



'Omment Procedures: Written comments con- 
cerning the rules by September /5, /989 to Lynda 
McDaniel, 70/ Barbour Drive, Raleigh, North 
Carolina 27603. Oral comments may be pre- 
sented at the hearing. 

CHAPTER 3 - FACILITY SERVICES 

SLBCIIAPTER 3D - RULES AND 

REGULATIONS GOVERNING A.MBULANCE 

SERVICE 

SECTION .0100 - DEFINITIONS (REPEALED) 

.010! AMBULANCE 



.0102 EMERGENCY MEDICAL TECHNICIAN 

.0103 AMBULANCE ATTENDANT 

.0104 LICENSE 

.0105 AMBULANCE PROVIDER 

.0106 HIGHWAY OR STREET 

.0107 APPROVED 

.0108 MOTOR VEHICLE 



Statutory Authority G.S. 
1 43 B-/ 65 (9 J. 



/3/E-/56; /43B-/65: 



.0110 PATIENT 

.01 1 1 QUALIFIED EMT INSTRUCTOR 

.0112 APPROVED TEACHING INSTITUTION 

.0113 COMMISSION 

.01 14 OFFICE OF EMERGENCY MEDICAL 

SFRVICES 
.01 15 MEDICAL CREW MEMBER 

Statutory Authority G.S. /3/E-/56; 

/3/E-/59(b): l43B-/65(9); /984 S.L.. c. /034. 

SECTION .0200 - A.MBULANCE EQUIPMENT 
(REPEALED) 

.0201 MEDICAL EQUIPMENT 
.0202 EXTRICATION AND ACCESS 

EQUIPMENT 
.0203 OTHER EQUIPMENT 

Statutory Authority G.S. /3/E-/57(a); 
/43B-/65(9). 

SECTION .0300 - WEAPONS AND EXPLOSIVES 
(REPEALED) 

.0301 WEAPONS .4ND EXPLOSIVES 

FORBIDDEN 
.0302 LAW ENFORCEMENT OFFICERS 

Statutory Authority G.S. /43B-/65. 

SECTION .0400 - SANITATION 
REQUIREMENTS (REPEALED) 

.0401 INTERIOR 

.0402 EQUIPMENT 

.0403 LINEN 

.0404 MEDICAL SUPPLIES 

.0405 PILLOWS AND MATTRESSES 

.0406 SOILED SUPPLIES 

.0407 SURFACES 

.0408 BLANKETS AND HAND TOWELS 

.0409 IMPLEMENTS INSERTED IN NOSE 

OR MOUTH 
.0410 COMMUNICABLE DISEASE 
.0411 STORAGE 
.0412 LAVATORY FACILITIES 

Statutory Authority G.S. /3/E-l57(a): 
/43B-/65(9). 



NORTH CAROLINA REGISTER 



377 



PROPOSED RULES 



SECTION .0500 - VEHICLE AND EQUIPMENT 
CRITERIA (REPEALED) 

.0501 INTERIOR DIMENSIONS 

.0502 INSPECTION CERTIFICATE 

.0503 WARNING DEVICES 

.0504 VEHICLE BODY 

.0505 OXYGEN CYLINDERS 

.0506 EQUIPMENT SECURED 

.0507 DOORS 

.0508 WINDOWS 

.0509 REAR-MEW MIRROR 

.0510 SEAT BELTS 

.0511 SPARE TIRE 

.0512 REPAIR EQUIPMENT 

.0513 DISPLAYED PERMIT 

.0514 PERMIT 

.0515 PERMITTED AMBULANCE 

.0516 AMBULANCE LETTERING: 

MARKINGS: SYMBOLS AND EMBLEMS 



CATEGORY IV AMBULANCES 



Statutory Authority 

131E-I5y(a); I43B-I65: 



G.S. I3IE-156: 

I43B-I65i9j: 143-508. 



SECTION .0600 - REQUIREMENTS FOR 

CERTIFICATION OF AMBULANCE 

ATTENDANT AND EMERGENCY MEDICAL 

TECHNICIAN (REPEALED) 

.0601 REQUIREMENT 

.0602 APPLICATION 

.0603 CERTIFICATE 

.0604 PinSICAL E.XAMINATION 

.0605 CHARACTER AND TEMPERAMENT 

.0606 APPEARANCE 

.0607 AGE 

.0608 LICENSES 



Statutorv 
131 E- 159(a): 
165. 



Authoritv G.S. I3IE-I5S: 

I3IE-I59(h): 1 31 E- 161: I43B- 



0610 SUBSTITUTION OF RN FOR 

EMERGENCY MEDICAL TECHNICIAN 

PROCEDURES FOR DENIAL: 

SUSPENSION: REVOCATION 

REASONS FOR DENIAL: SUSPENSION: 

REVOCATION 

TR.MNING FOR INITIAL 

CERTIFICATION 

TRAINING FOR RECERTIFICATION 

EX.WIINATION FOR INITIAL 

CERTIFICATION 

EXAMINATION FOR RECERTIFICATION 



.0611 

.0612 

.0613 

.0614 
.0615 

.0616 



Statutorv Authoritv G.S. I3IE-I5S: 

I3IE-I59(a): I31E-I59(b): 19S4 S.L.. c. 1034. 

SECTION .0700- PERSONNEL REQl IREMENTS 

FOR CATEGORY l\ AMBULANCES 

(REPE,\LED) 

.0701 PERSONNEL REQUIREMENTS FOR 



Statutory A uthority 
1 438-165(9). 



G.S. I3IE-I65(a); 



SECTION .0800 - DEFINITIONS 

.0801 AMBULANCE 

(a) "Ambulance" means any privately or pub- 
licly owned motor vehicle, aircraft, or vessel that 
is specifically designed, constructed, or modified 
and equipped; and is intended to be used for and 
is maintained or operated for the transportation 
on the streets, highways, waterways or airways 
of this state of f)er5ons who are sick, injured, 
convalescent, or otherwise incapacitated or help- 
less. 

(b) An ambulance must be issued a permit by 
the Department of Human Resources, Division 
of Facility Services, Office of Emergency Medical 
Services in one of the following categories: 

(1) "Category I Ambulance" means an emer- 
gency vehicle used to transport patients 
with emergency traumatic or medical 
conditions or patients for which the need 
for emergency medical care is anticipated 
either at the scene of the emergency or 
enroute to a medical facility. Category I 
ambulances may be used to transport all 
types of patients. 

(2) "Category II Ambulance" means a vehicle 
used solely to transport sick or infirm pa- 
tients, having a known, non-emergency 
medical condition, on a scheduled basis 
between facilities or between a residence 
and a facility. Categor>' II ambulances 
must not be used to transport patients 
defined under any other category of am- 
bulance. 

(3) "Category III Ambulance" means an 
emergency vehicle specifically designed 
and equipped to transfer critically ill pa- 
tients from one medical facility to another 
or as ground support to a permitted air 
ambulance program. The patient care 
compartment of Category III ambulances 
must be staffed by appropriately certified 
or licensed personnel approved for the 
mission by the program medical director. 
Categorv' III ambulances must be utilized 
as part of an organized cntical care trans- 
port program and may not be used in 
place of any other category of ambulance 
defmed in this Subchapter. 

(4) "Category IV .Ambulance" means an air- 
craft specifically designed and equipped to 
transport patients. Category IV ambu- 
lances must be operated as either; 



i~<y 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(A) Part of an approved mobile intensive 
care program and must comply with the 
criteria as outlined in 21 NCAC 32H; or 

(B) Part of an air ambulance program 
which complies with 21 NCAC 32H 
.1004. 

(5) "Category V Ambulance" means a water- 
craft specifically designed and equipped to 
routinely transport patients. 



Statutory Authority G.S. 1 43 B- 1 65. 

.0807 PATIENT 

"Patient" means an individual who is sick, in- 
jured, convalescent, or otherwise incapacitated 
or helpless where the need for some medical as- 
sistance might be anticipated while being trans- 
ported to or from a medical facility. 



Statutory Authority G.S. I3IE-I56; I43B-I65(9). Statutory Authority G.S. I43B-I65(9). 



.0802 EMERGENCY MEDICAL TECHNICIAN 

The term "emergency medical technician" 
(EMT) means a person trained in a program ap- 
proved by the Office of Emergency Medical Ser- 
vices who has been certified or recertified by the 
Commission as qualified to perform the skills 
enumerated in Rule . 1406 of this Subchapter. 

Statutory Authority G.S. I43B-I65. 

.0803 AMBULANCE ATTENDANT 

The term "ambulance attendant" (AA) means 
a person trained in a program approved by the 
Office of Emergency Medical Services, who has 
been certified or recertified by the Commission 
to assist emergency medical technicians in per- 
forming the skills enumerated in Rule .1405 of 
this Subchapter. 

Statutory .Authority G.S. 143B-I65. 

.0804 AMBLLANCE PROVIDER 

"Ambulance provider" means an individual, 
firm, corporation, government agency, or associ- 
ation who engages or professes to engage in the 
business or service of transporting patients in an 
ambulance. 

Statutory Authority G.S. I43B-I65(9). 

.0805 HIGHWAY OR STREET 

The term "highway or street" shall mean the 
entire width between property or right-of-way 
lines of every way or place of whatever nature, 
when any part thereof is open to the use of the 
pubUc as a matter of right for the purpose of ve- 
hicle traffic. The terms "highway" or "street" 
or their cognates are synonymous. 

Statutory Authority G.S. I43B-I65. 

.0806 APPROVED 

The term "approved" shall mean approved by 
the North Carolina Medical Care Commission 
or the North Carolina Board of Medical Exam- 
iners. 



.0808 QUALIFIED EMT INSTRUCTOR 

The term "qualified EMT instructor" means a 
person who instructs or coordinates EMS train- 
ing programs and continuing education programs 
that meet the criteria defined in Rule . 1402 of this 
Subchapter. 

Statutory Authority G.S. I3IE-I59(b). 

.0809 APPROVED TEACHING INSTITUTION 

The term "approved teaching institution" me- 
ans any agency with a current memorandum of 
agreement with the Office of Emergency Medical 
Services to provide emergency medical services 
training programs. Approved teaching insti- 
tutions must meet the criteria found in Rule 
.1401 of this Subchapter. 

Statutory Authority G.S. I3IE-I59(b). 

.0810 COMMISSION 

The term "Commission" means the North Ca- 
rolina Medical Care Commission. 

Statutory Authority G.S. I3IE-I59(b). 

.0811 OFFICE OF EMERGENCY MEDICAL 
SERVICES 

The term "Office of Emergency Medical Ser- 
vices" means a section of the Division of Facility 
Services of the North Carolina Department of 
Human Resources located at 701 Barbour Drive, 
Raleigh, North Carolina 27603. 

Statutory Authority G.S. I3IE-I59(b). 

.0812 MEDICAL CREW MEMBER 

The term "medical crew member" means a 
physician, registered nurse, EMT-paramedic, 
EMT-advanced intermediate, EMT-intermediate, 
EMT-defibrillation technician or EMT who 
holds a current North Carolina license or certif- 
ication and who has completed additional train- 
ing in altitude physiology, EMS 
communications, in-flight emergencies, and air- 
craft and flight safety conducted under the direct 



NORTH CAROLINA REGISTER 



379 



PROPOSED RULES 



guidance of the medical director for the program 
m which he functions. 

Statutory Authority G.S. I3IE-156; I43B-I65(9). 

.0813 PHYSICIAN 

The term "physician" means an individual li- 
censed by the Board of Medical Examiners to 
practice medicine in the State of North Carolina. 

Statutory Authority G.S. I43B-I65. 

.0814 REGISTERED NLRSE 

The term "registered nurse" means an individual 
licensed by the Board of Nursing to practice 
nursing in the State of North Carolina. 

Statutory Authority G.S. I43B-I65. 

.0815 AMBULANCE SERVICE AREA 

The term "ambulance service area" means a 
geographical area with boundaries defmed by the 
county or EMS provider serving that area. 

Statutory Authority G.S. 1438-165. 

.0816 CRITICAL CARE TRANSPORT 
PROGR.WI 

The term "critical care transport program" me- 
ans a defmed system of care during transport 
from one medical facility to another for patients 
suffering from a specific mjury or medical condi- 
tion (i.e., neonatal, high risk obstetrics, bum, 
etc.). Such programs must include, at a mini- 
mum, a designated physician medical director 
and written transfer protocols. 

Statutory Authority G.S. 1 438- 165. 

SECTION .0900 - VEHICLES 

.0901 INTERIOR DIMENSIONS 

(a) Any vehicle issued a permit as a Category 
I or Category III ambulance must have the fol- 
lowing minimum patient compartment interior 
dimensions: 

(1) The length, measured on the floor from 
the back of the driver's compartment, 
driver's seat or partition to the inside edge 
of the rear loading doors, must be at least 
108 inches. 

(2) The width of the compartment after cabi- 
net and cot installation must provide at 
least 1 1 inches of clear aisle walkway be- 
tween the primary cot and the squad 
bench, a second cot or curbside wall of the 
vehicle. 

(3) The height must be at least 52 inches over 
the patient area, measured from the ap- 



(2) 



(3) 



(c) 
(1) 



(2) 



proximate center of the floor, exclusive of 
cabinets or equipment. 
(b) Any vehicle issued a permit as a Category 

II ambulance to an ambulance provider must 
have the following minimum patient compart- 
ment interior dimensions: 

(1) TTie length, measured on the floor from 
the back of the driver's compartment, 
driver's seat, or partition to the mside edge 
of the rear loading doors must be at least 
102 inches. 

The width of the compartment after cabi- 
net and cot installation must provide for 
at least 1 1 inches of clear aisle walkway 
between the cot and the squad bench, a 
second cot or the curbside wall of the ve- 
hicle. 

The height must be at least 48 inches over 
the patient area measured from the ap- 
proximate center of the floor, exclusive of 
cabinets or equipment. 
Category IV ambulances must have: 

A patient care area sufficiently isolated 
from the cockpit to minimize inflight dis- 
tractions and interference while providing 
sufficient working space to render patient 
care; and 

Door openings of sufficient size to permit 
the safe loading and unloading of a person 
occupying a litter. 
(d) Category V ambulances must have a patient 
care area which: 

(1) Provides access to the head, torso, and 
lower extremities of the patient while 
providing sufficient working space to ren- 
der patient care; 

(2) Is covered to protect the patient and the 
technician from the elements; and 

(3) Has an opening of sufficient size to permit 
the safe loading and unloading of a person 
occupying a litter. 

Statutory Authority G.S. I3IE-I57(a). 

.0902 INSPECTION CERTIFICATE 

.Any vehicle issued a fjermit as a Category I, II, 
or III ambulance must have a current safety 
equipment inspection certificate issued by the 
North Carolina Division of .Motor Vehicles. 

Statutory Authority G.S. 13IE-I57(a). 

.0903 WARNING DEVICES 

(a) Each Category I ambulance and Category 

III ambulance for which a permit is issued must 
have emergency warning lights and audible 
warning devices other than those required by 
Federal Motor Vehicle Safetv Standards. ^Vll 



iSO 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



warning devices must function in the manner in 
which they were designed to function. 

(b) Each Category II ambulance for which a 
permit is issued shall not be equipped, perma- 
nently or temporarily, with emergency warning 
devices, audible or visual, other than those re- 
quired by Federal Motor Vehicle Safety Stand- 
ards. 

(c) Each Category' V ambulance for which a 
permit is issued must have a 360 degree beacon 
warning light in addition to warning de\ices re- 
quired in Chapter 75A /Vrticle 1 of the North 
Carolina Statutes. 

Statutory Authority G.S. I3IE-I57(a). 

.0904 VEHICLE BODY 

The ambulance vehicle body must be free from 
defects that could adversely affect the safe op>era- 
tion of the vehicle. 

Statutory Authority G.S. I3IE-I57(a). 

.0905 OXYGEN CYLINDERS 

Oxygen cylinders used in ambulance vehicles 
must bear static pressure date and must be re- 
placed or refilled as soon as possible after use. 

Statutory Authority G.S. I3IE-I57(a). 

.0906 EQUIPMENT SECLRED 

/MI equipment in the patient compartment must 
be adequately secured. 

Statutory Authority G.S. I3IE-I57(a). 

.0907 DOORS 

All doors leading into passenger and patient 
compartment must open properly and close se- 
curely with all hardware working properly. 

Statutory Authority G.S. I31E-I57(a). 

.0908 WINDOWS 

Windows and windshield must be clear and free 
of cracks. 

Statutory Authority G.S. I3IE-I57(a}. 

.0909 RE.\R-VIEW MIRROR 

Rear-view mirror utilized in Category I, II, or 
III ambulances must be free of cracks and blem- 
ishes. 

Statutory Authority G.S. 131 E- 1 57(a). 

.0910 SEAT BELTS 



Seat belts must be in place and in a useable 
condition for all Category I, II, III, and IV am- 
bulances. 

Statutory Authority G.S. I3IE-I57(a). 

.0911 SPARE TIRE 

Ambulance vehicles issued permits as Category 
I, II, or III must carry a serviceable spare tire and 
equipment to change a flat tire or unserviceable 
tire. An acceptable alternative to this require- 
ment is an immediately available service vehicle 
or a plan for the immediate dispatch of another 
ambulance. 

Statutory Authority G.S. I3IE-I57(a). 

.0912 DISPLAYED PER.MIT 

Any ambulance, after meeting the requirements 
of the rules contained in this Subchapter, must 
display a current ambulance permit issued by the 
Office of Emergency Medical Services at such a 
place on the vehicle as designated by a represen- 
tative of the Office of Emergency Medical Ser- 
vices, indicating the vehicle has been inspected in 
accordance with the rules contained in this Sub- 
chapter. 

Statutory Authority G.S. I3IE-I57(a). 

.0913 PERMIT 

(a) The ambulance permit must include the 
following information: 

(1) vehicle identification number; 

(2) permit number; 

(3) ambulance provider identification number; 

(4) identification of inspector; and 

(5) expiration date. 

(b) ^'Vmbulance permits issued shall be valid for 
a period not to exceed one year. The Office of 
Emergency Medical Services may issue tempo- 
rary permits for vehicles not meeting required 
standards for a period not to exceed 60 days, 
when it determines that the best interest of the 
public will best be served by doing so. 

(c) No person shall display or cause to be dis- 
played or permit to be displayed or to knowingly 
possess, transfer, remove, imitate, or reproduce 
an ambulance permit, except by direction of the 
Office of Emergency Medical Services. 

(d) /Vn ambulance shall be permitted in only 
one category. 

Statutory Authority G.S. I3IE-I57(a). 

.0914 PERMIT REQUIRED 

No vehicle, aircraft, or watercraft shall be 
deemed an ambulance for the purpose of law 



NORTH CAROLINA REGISTER 



3S1 



PROPOSED RULES 



unless the said vehicle, aircraft, or watercraft has 
been issued an ambulance permit by the Office 
of Emergency Medical Services, m accordance 
with this Subchapter. It shall be the responsi- 
bility of the ambulance provider to apply to the 
OtTice of Emergency Medical Services for a per- 
mit to operate that ambulance. 

Statuton- Authority G.S. /3JE-I57iaJ. 

.0915 AMBL LANCE LETTERING: 

MARKINGS: SYMBOLS AND EMBLEMS 

(a) Each ambulance must have the name of the 
ambulance provider permanently displayed on 
each side of the vehicle in letters at least three 
inches high. 

(b) Cateeop.' II ambulances must have the 
words "CONVALESCENT AMBLLANCE" 
permanently lettered on both sides and on the 
rear of the vehicle body in at least five inch let- 
ters. 

(c) Category" II ambulances may not use 
emergency medical symbols, such as the Star of 
Life, block design cross, or any other medical 
markings, symbols, or emblems, including the 
word "EMERGENCY," on the vehicle or in any 
advertisement, publication, or literature pertam- 
ina to Categor.' II ambulance services. 



His ton' Sote: 
ISIE-IS^ia). 



Statutory Authority G.S. 



.0916 INTERIOR 

The interior of the ambulance and the equip- 
ment within the ambulance shall be sanitar,' and 
maintained in good working order at all times. 

Statutory Authority G.S. 13IE-I57(aj. 

.0917 EQUIPMENT 

Equipment shall be of smooth and easily clean- 
able construction. 

Statutory Authority G.S. 131E-157(a). 

.0918 LINEN 

(a) Freshly laundered linen or disposable hnen 
shall be used on cots and pillows and linen shall 
be changed after each patient is transported. 

(b) Clean linen storage shall be provided on 
each ambulance. 

Statutory Authority G.S. 131 E-l 57(a). 

.0919 MEDICAL SLPPLIES 

Closed compartments shall be provided within 
the ambulance for medical supplies. 

Statutory .Authority G.S. 131 E-I5'^(a). 



.0920 PILLOWS AND MATTRESSES 

Pillows and mattresses shall be kept clean and 
in good repair. 

Statutory Authority G.S. 131 E-l 57(a). 

.0921 SOILED SLPPLIES 

Closed containers shall be provided for soiled 
supplies. 

Statutory Authority G.S. I3IE-I57(a). 

.0922 SURFACES 

Exterior and interior surfaces of ambulance shall 
be cleaned routinely. 

Statutory Authority G.S. I3IE-I57(a). 

.0923 BL.4NKETS .\ND H.\ND TOWELS 

Blankets and hand towels used in any ambu- 
lance shall be clean. 

Statutory Authority G.S. I3IE-I57(a). 

.0924 IMPLEMENTS INSERTED IN NOSE 
OR MOUTH 

la) Implements inserted into the patient's nose 
or mouth shall be single -service, wrapped and 
properly stored and handled. 

(b) When multi-use items are used, the local 
health care facilities and or County Health De- 
partment should be consulted for instructions in 
sanitation and handling of such items. 

Statutory Authority G.S. I31E-I57(a). 

.0925 INFECTION CONTROL 

When an ambulance has been utilized to trans- 
port a patient known to the ambulance providers 
to have a communicable disease, it is the re- 
sponsibility of the ambulance provider to ensure 
that the ambulance, including its equipment and 
supplies, is taken out of service until appropri- 
ately cleansed and disinfected according to local 
infection control policy. 

Statutory Authority G.S. I31E-I5^(a). 

.0926 STORAGE 

(a) -AH storage spaces used for storage of linens, 
equipment, medical supplies and other supplies 
at base stations shall be kept clean and free from 
unnecessarN' articles. 

(b) The contents shall be arranged so as to 
permit thorough cleaning. 

Statutory' .Authority G.S. I3IE-I57(a). 



382 



iWRTH CAROLINA REGISTER 



PROPOSED RULES 



SECTION .1000 - AMBULANCE EQLIPMENT 

.1001 MEDICAL AND RELATED EQLIPMENT 

(a) Category I ambulances for which permits 
are issued shall contain at least the following 
equipment exclusive of personal equipment car- 
ried by emergency medical technicians and am- 
bulance attendants: 

(1) One portable aspirator capable of a min- 
imum vacuum of 300 millimeters of mer- 
cury and a minimum air flow rate of 16 
liters per minute with rapid drawdown 
time. A minimum of three, single use, 
non-opaque, one piece, rigid suction in- 
struments and a suction rinsing water 
bottle must be supplied with this unit; 

(2) One each portable squeeze bag ventilation 
unit (bag and mask) in adult and child 
sizes with transparent face mask capable 
of low temperature operation (32 degrees 
F or below) and an attachment for oxygen 
hookup. A minimum of two transparent, 
flexible, disposable oxygen supply tubes 
must be supplied with each unit; 

(3) Six nonmetalhc, oropharyngeal airways 
sanitarily stored together in separate sizes 
ranging from 55 millimeters through 1 1 5 
millimeters; 

(4) One bite stick either commercially man- 
ufactured or made of three tongue blades 
taped together and padded; 

(5) One portable oxygen unit consisting of 
the following components: 360 liter (D 
size) or larger oxygen cylinder; yoke regu- 
lator with cylinder contents gauge (2000 
pounds per square inch) and gravity or 
non-gravity dependent flow gauge (0-12 
liters per minute minimum); a minimurrj 
of three transparent, nasal cannulas in 
adult and child sizes; and a minimum of 
three each, adult and child, disposable, 
transparent, oxygen masks with delivery 
tubes and headband. A full spare cylinder 
(D size) of oxygen for this unit shall be 
furnished and stored on the ambulance 
vehicle; oxygen tanks must show date of 
last static test; 

(6) One small, one medium, and one large 
size adult extrication collar and one pe- 
diatric size extrication collar; 

(7) One rigid short backboard. The mini- 
mum size must be 14 inches wide by 32 
inches long. A stabilization device which 
is of the design to allow horizontal flexi- 
bility and vertical rigidity, equipped with 
chest and leg straps and accessories for 
stabilization of the head and neck may be 
substituted for the rigid short backboard; 



(8) One rigid long backboard a minimum of 
16 inches wide by 72 inches long with two 
straps for patient stabilization and other 
accessories for stabilization of the head 
and neck; 

(9) Two sets of rigid padded board splints in 
the following sizes; three inches wide by 
15 inches long, three inches wide by three 
feet long, and three inches wide by four 
and one-half feet long. Other splints, in 
kit form, of inflatable design or rigid lam- 
inated and high density polyurethane 
foam construction are acceptable. A kit 
must contain at least two full leg and two 
full arm splints; 

(10) One child and one adult size lower ex- 
tremity traction splint with appropriate 
attachments; 

(11) Two sandbags constructed of a nonpo- 
rous material for immobilization pur- 
poses. .Minimum size must be two inches 
by four inches by 12 inches. A head im- 
mobilizer may be substituted for sand- 
bags; 

(12) Twelve four inch by four inch sterile 
gauze pads individually packaged; 

(13) Six sterile five inch by nine inch absor- 
bent dressings individually wrapped; 

( 14) Twelve roUs of roller gauze; 

(15) Four roUs of adhesive tape; 

(16) Four stenle nonadhering, nonporous 
dressings for an open chest wound. Min- 
imum size shall be three inches by eight 
inches; 

(17) Six triangular bandages; 

(18) Two pairs of five and one-half inches 
bandage shears; 

(19) Two sterile bum sheets, minimum size 
of 40 inches by 72 inches; 

(20) A total of 2000 cubic centimeters of 
sterile irrigating solution in plastic con- 
tainers in addition to the fluids carried for 
intravenous use; 

(21) One emesis basin; 

(22) One obstetrical kit containing gloves, 
scissors or surgical blades, umbilical cord 
clamps or tapes, dressings, towels, perina- 
tal pad, a bulb syringe, and a receiving 
blanket; 

(23) One poison antidote kit containing syrup 
of ipecac, activated charcoal and a means 
of administering the proper dosage; 

(24) One each small, regular and large size 
aneriod blood pressure cuff and adult and 
pediatric stethoscopes. One stethoscope 
with adult and pediatric attachments is 
acceptable; 



NORTH CAROLINA REGISTER 



iSi 



PROPOSED RULES 



(25) One sheet of rubber or heavy plastic, 
minimum size of 36 inches by 72 inches, 
or one body bag; 

(26) One four wheeled, elevating cot with a 
minimum three inch thick pad with a 
nonporous cover. The cot must be 
equipped with restraining straps (chest 
and thigh area) of at least two inches in 
width. A crash stable fastener installed 
per the cot manufacturer's instructions 
and compatible with the model cot fur- 
mshed must secure the specified cot to the 
floor or side wall: 

(27) One additional stretcher with patient re- 
straining straps and capable of being se- 
cured inside the patient compartment; 

(28) Two sets of clean cot linen constructed 
of washable or disposable material in ad- 
dition to a set on the cot (a set equals two 
sheets and one pillowcase); 

(29) Two pillows covered with a nonporous 
matenaJ; 

(30) Two blankets constructed of washable 
material; and 

(31) One child restraint device to safely trans- 
port pediatric patients in the patient com- 
partment of the ambulance. 

(b) Category II ambulances for which permits 
are issued shall contain at least the following 
equipment exclusive of personal equipment car- 
ried by personnel: 

(1) One portable aspirator capable of a min- 
imum vacuum of 300 millimeters of mer- 
cury and a minimum air flow rate of 16 
liters per minute with rapid drawdown 
time. A minimum of three, single use, 
non-opaque, one piece, ngid suction in- 
struments and a suction rinsing water 
bottle must be supplied with this unit; 

(2) One each portable squeeze bag ventilation 
unit (bag and mask) in adult and child 
sizes with transparent face mask capable 
of low temperature operation (32 degrees 
F or below) and an attachment for oxygen 
hookup. A minimum of two transparent, 
flexible, disposable oxygen supply tubes 
must be supplied with each unit; 

(3) Six nonmetallic, oropharyngeal airways 
sanitarily stored together in separate sizes 
ranging from 55 millimeters through 115 
millimeters: 

(4) One bite stick either commercially man- 
ufactured or made of three tongue blades 
taped together and padded; 

(5) One portable oxygen unit consisting of 
the following components: 360 liter (D 
size) or larger oxygen cylinder; yoke regu- 
lator with cylinder contents gauge (2000 



pounds per square inch) and gravity or 
non-gravity dependent flow gauge (0-12 
liters per minute); a minimum of three 
transparent, nasal carmulas in adult and 
child sizes; and a minimum of three each, 
adult and child, disposable, transparent, 
oxygen masks with delivery tubes and 
headband. A fuU spare cylinder (D size) 
of oxygen for this umt shall be furnished 
and stored on the ambulance vehicle: ox- 
ygen tanks must show date of last static 
test; 

(6) Twelve four inch by four inch sterile 
gauze pads individually packaged: 

(7) Six sterile five inch by nine inch absorbent 
dressings individually wrapped; 

(8) Six rolls of roller gauze; 

(9) Two rolls of adhesive tape; 

(10) Three triangular bandages; 

(11) Two pairs of five and one-half inches 
bandage shears; 

(12) One emesis basin; 

(13) One each small, regular and large size 
aneriod blood pressure cuff and adult and 
pediatric stethoscopes. One stethoscope 
with adult and pediatric attachments is 
acceptable; 

( 14) One four wheeled, elevating cot with a 
minimum three inch thick pad with a 
nonporous cover. The cot must be 
equipped with restraining straps (chest 
and thigh area) of at least two inches in 
width. A crash stable fastener installed 
per the cot manufacturer's instructions 
and compatible with the model cot fur- 
nished must secure the specified cot to the 
floor or side wall; 

(15) Two sets of clean cot linen constructed 
of washable or disposable material in ad- 
dition to a set on the cot (a set equals two 
sheets and one pillowcase): 

(16) Two piUows covered with a nonporous 
material; 

(17) Two blankets constructed of washable 
material; 

(18) A firm board of minimum size 14 inches 
by 32 inches to support the back during 
manual heart compressions; and 

( 1 9) One child restraint device to safely trans- 
p>ort pediatric patients in the patient com- 
partment of the ambulance. 

(c) Category III ambulances for which permits 
are issued shall contain at least the following 
equipment exclusive of personal equipment car- 
ried by personnel: 

(1) One portable aspirator capable of a min- 
imum vacuum of 300 millimeters of mer- 
cur>' and a minimum air flow rate of 16 



3S4 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



liters per minute with rapid drawdown 
time. A minimum of three, single use, 
non-opaque, one piece, rigid suction in- 
struments and a suction rinsing water 
bottle must be supplied with this unit; 

(2) One each portable squeeze bag ventilation 
unit (bag and mask) in adult and child 
sizes with transparent face mask capable 
of low temperature operation (32 degrees 
F or below) and an attachment for oxygen 
hookup. A minimum of two transparent, 
flexible, disposable oxygen supply tubes 
must be supplied with each unit; 

(3) Six nonmetaUic, oropharyngeal airways 
sanitarily stored together in separate sizes 
ranging from 55 millimeters through 115 
millimeters; 

(4) One bite stick either commercially man- 
ufactured or made of three tongue blades 
taped together and padded; 

(5) One portable oxygen unit consisting of 
the following components: 360 liter (D 
size) or larger oxygen cylinder; yoke regu- 
lator with cylinder contents gauge (2000 
pounds per square inch) and gravity or 
non-gravity dependent flow gauge (0-12 
liters per minute); a minimum of three 
transparent, nasal cannulas in adult and 
child sizes; and a minimum of three each, 
adult and child, disposable, transparent, 
oxygen masks with delivery tubes and 
headband. A full spare cylinder (D size) 
of oxygen for this unit shall be furnished 
and stored on the ambulance vehicle; ox- 
ygen tanks must show date of last static 
test; 

(6) Twelve four inch by four inch sterile 
gauze pads individually packaged; 

(7) Six sterile five inch by nine inch absorbent 
dressings individually wrapped; 

(8) Six rolls of roller gauze; 

(9) Two rolls of adhesive tape; 

( 1 0) Three triangular bandages; 

(11) Two pairs of five and one-half inches 
bandage shears; 

(12) One emesis basin; 

(13) Two sterile bum sheets, minimum size 
of 40 inches by 72 inches; 

(14) A total of 2000 cubic centimeters of 
sterile irrigating solution in plastic con- 
tainers in addition to the fluids carried for 
intravenous use; 

(15) One obstetrical kit containing gloves, 
scissors or surgical blades, umbilical cord 
clamps or tapes, dressings, towels, perina- 
tal pad, a bulb syringe, and a receiving 
blanket; 



(16) One poison antidote kit containing syrup 
of ipecac, activated charcoal and a means 
of administering the proper dosage; 

(17) One each small, regular and large size 
aneriod blood pressure cuff and adult and 
pediatric stethoscopes. One stethoscope 
with adult and pediatric attachments is 
acceptable; 

(18) One four wheeled, elevating cot with a 
minimum three inch thick pad with a 
nonporous cover. The cot must be 
equipped with restraining straps (chest 
and thigh area) of at least two inches in 
width. A crash stable fastener installed 
per the cot manufacturer's instructions 
and compatible with the model cot fur- 
nished must secure the specified cot to the 
floor or side wall. A self contained trans- 
port incubator with stand and capable of 
being secured in the ambulance may be 
substituted; 

(19) Two sets of clean cot linen constructed 
of washable or disposable material in ad- 
dition to a set on the cot (a set equals two 
sheets and one pillowcase); 

(20) Two pillows covered with a nonporous 
material; 

(21) Two blankets constructed of washable 
material; 

(22) A firm board of minimum size 14 inches 
by 32 inches to support the back during 
manual heart compressions; and 

(23) One child restraint device to safely trans- 
port pediatric patients in the patient com- 
partment of the ambulance. 

(d) Category IV ambulances for which permits 
are issued must have the following medical 
equipment immediately available to be placed on 
the aircraft: 

(1) One portable aspirator with rapid draw- 
down time capable of providing a mini- 
mum vacuum of 300 millimeters of 
mercury and a minimum air flow rate of 
16 Uters per minute up to the maximum 
operating altitude of the aircraft. A mini- 
mum of three, single use, non-opaque, 
one piece, rigid suction instruments and a 
suction rinsing water bottle must be sup- 
phed with this unit; 

(2) One each portable squeeze bag ventilation 
unit (bag and mask) in adult and child 
sizes with transparent face mask capable 
of low temperature operation (32 degrees 
F or below) and an attachment for oxygen 
hookup. A minimum of two transparent, 
disposable oxygen supply tubes must be 
supplied with each unit; 



NORTH CAROLINA REGISTER 



385 



PROPOSED RULES 



(3) Six nonmetallic, oropharvngeal airways 
sanitanly stored together in separate sizes 
ranging from 55 millimeters through 115 
millimeters: 

(4) One bite stick either commercially man- 
ufactured or made of three tongue blades 
taped together and padded; 

(5) Oxygen unit contaimng a quantity of ox- 
ygen sutTicient to supply an appropriate 
flow rate for the period of time it is antic- 
ipated oxygen vsill be needed, but not less 
than ten liters per minute for 30 minutes. 
The oxygen shall be carried in two sepa- 
rate containers, one of which must be 
portable. The portable oxygen umt shall 
have a yoke regulator with cylinder con- 
tents gauge, flow gauge, and DISS outlets; 

(6) Twelve four inch by four inch sterile 
gauze pads individually packaged; 

(7) Six sterile five inch by nine inch absorbent 
dressings individually wrapped; 

(8) Twelve rolls of roller gauze; 

(9) Four rolls of adhesive tape; 

(10) Four sterile nonadhering, nonporous 
dressings for an open chest wound. Min- 
imum size shall be 3 inches by S inches; 

(11) Six tnangular bandages; 

(12) Two sterile bum sheets, minimum size 
of 40 inches by 72 inches; 

(13) A total of 2000 cubic centimeters of 
sterile irrigating solution in plastic con- 
tainers in addition to the fluids carried for 
intravenous use; 

(14) One emesis basin; 

( 1 5) One IV pressure bag; 

( 16) /\n electronic means of measuring blood 
pressure while in flight; 

(17) One stethoscope and manual blood 
pressure cuff; 

(18) One ECG monitor defibrillator; 

(19) One complete kit for endotracheal intu- 
bation; 

(20) One litter and attachment for securing the 
litter to the airframe inside the cabin of 
the aircraft. The litter must allow for el- 
evation of the patient's head; 

(21) One blanket constructed of washable 
material; 

(22) Four air sick bags; and 

(23) Four IV hooks. 

(e) The combination of medical equipment 
specified in Paragraph (d) of this Rule that is 
carried on a mission may be varied if, in the 
opinion of the medical director, such variation is 
in the best interest of patient care. 

(f) AH rotary wing aircraft permitted as a Cat- 
egorv' IV ambulance must have the following 
flight equipment operational in the aircralt: 



(1) Two 360 channel VHF aircraft frequency 
transceivers; 

(2) One VHF omnidirectional ranging 
(VOR) receiver; 

(3) Attitude indicators; 

(4) One nondirectional beacon (NDB) re- 
ceiver; 

(5) One glide scope receiver; 

(6) One transponder with 4097 code. Mode 
C; 

(7) Turn and slip indicator m the absence of 
three attitude indicators; 

(8) Current FAA approved navigational aids 
and charts for the area of operations; 

(9) Radar altimeter; and 

(10) Loran navigational system. 

(g) Any fixed wing aircraft issued a permit as a 
Category IV ambulance must have a current 
"Instrument Flight Rules" certification. 

(h) Categorv' V ambulances for which permits 
are issued shall contain at least the following 
equipment exclusive of personal equipment car- 
ried by personnel: 

(1) One portable aspirator capable of a min- 
imum vacuum of 300 millimeters of mer- 
cury and a minimum air flow rate of 16 
liters per minute with rapid drawdown 
time. A minimum of three, single use, 
non-opaque, one piece, rigid suction in- 
struments and a suction nnsing water 
bottle must be supplied with this unit; 

(2) One each portable squeeze bag ventilation 
unit (bag and mask) in adult and child 
sizes with transparent face mask capable 
of low temperature operation (32 degrees 
F or below) and an attachment for oxygen 
hookup. A minimum of two transparent, 
flexible, disposable oxygen supply tubes 
must be supplied with each unit; 

(3) Six nonmetallic, oropharyngeal airways 
sanitarily stored together in separate sizes 
ranging from 55 millimeters through 115 
millimeters; 

(4) One bite stick either commercially man- 
ufactured or made of three tongue blades 
taped together and padded; 

(5) One portable oxygen unit consisting of 
the following components: 360 liter (D 
size) or larger oxygen cylinder; yoke regu- 
lator with cylinder contents gauge (2000 
pounds per square inch) and gravity or 
non-gravity dependent flow gauge (0-12 
liters per minute); a minimum of three 
transparent, nasal cannulas in adult and 
child sizes; and a minimum of three each, 
adult and child, disposable, transparent, 
oxygen masks with delivery tubes and 
headband. A full spare cylinder (D size) 



586 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



of oxygen for this unit shall be furnished 
and stored on the ambulance vehicle; ox- 
ygen tanks must show date of last static 
test: 

(6) One small, one medium, and one large 
size adult extrication collar and one pe- 
diatric size extrication collar; 

(7) One rigid short backboard. The mini- 
mum size must be 14 inches wide by 32 
inches long. A stabilization device which 
is of the design to allow horizontal flexi- 
bility and vertical ngidity, equipped with 
chest and leg straps and accessories for 
stabilization of the head and neck may be 
substituted for the rigid short backboard; 

(8) One floatable rigid long backboard a mi- 
nimum of 16 inches wide by 72 inches 
long with two straps for patient stabiliza- 
tion and other accessories for stabilization 
of the head and neck; 

(9) Two sets of rigid padded board splints in 
the following sizes; three inches wide by 
1 5 inches long, three inches wide by three 
feet long, and three inches wide by four 
and one-half feet long. Other splints, in 
kit form, of inflatable design or rigid lam- 
inated and high density polyurethane 
foam construction are acceptable. A kit 
must contain at least two full leg and two 
full arm splints; 

(10) One child and one adult size lower ex- 
tremity traction splint with appropriate 
attachments; 

(11) Two sandbags constructed of a nonp>o- 
rous matenal for immobilLzation pur- 
poses. Minimum size must be two inches 
by four inches by 12 inches. A head im- 
mobilizer may be substituted for sand- 
bags; 

(12) Twelve four inch by four inch sterile 
gauze pads individually packaged; 

(13) Six sterile five inch by nine inch absor- 
bent dressings individually wrapp>ed; 

( 14) Twelve rolls of roller gauze; 

( 1 5) Four rolls of adhesive taf)e; 

(16) Four sterile nonadhering, nonporous 
dressings for an open chest wound. Mm- 
imum size shall be three inches by eight 
inches; 

(17) Six triangular bandages; 

(18) Two pairs of five and one-half inches 
bandage shears; 

(19) Two sterile bum sheets, minimum size 
of 40 inches by 72 inches; 

(20) A total of 2000 cubic centimeters of 
sterile irrigating solution in plastic con- 
tainers m addition to the fluids carried for 
intravenous use; 



(21) One emesis basin; 

(22) One obstetrical kit containing gloves, 
scissors or surgical blades, umbilical cord 
clamps or tapes, dressings, towels, p>erina- 
tal pad, a bulb syringe, and a receiving 
blaiiket; 

(23) One poison antidote kit containing syrup 
of ipecac, activated charcoal and a means 
of administering the proper dosage; 

(24) One each small, regular and large size 
aneriod blood pressure cuff and adult and 
pediatric stethoscopes. One stethoscope 
with adult and pediatric attachments is 
acceptable; 

(25) One sheet of rubber or heavy plastic, 
minimum size of 36 inches by 72 inches, 
or one body bag; 

(26) One additional floatable litter with pa- 
tient restraining straps and capable of be- 
ing secured to the watercraft; and 

(27) Two blankets constructed of washable 
material. 



Statutory A uthority 
1438-165(9). 



G.S. I3IE-I57(a); 



.1002 EXTRICATION AND ACCESS 
EQUIPMENT 

Category I ambulances for which permits are 
issued must contain at least the foUowmg equip- 
ment: 

(1) One ten-inch adjustable open end wrench; 

(2) One screwdriver with flat blade; 

(3) One screwdriver with Phillips blade; 

(4) One hacksaw with a minimum of six 
blades; 

(5) One four-pound hammer with IS-inch 
handle; 

(6) One pair of pliers, ten-inch vise-grip; 

(7) One 24-inch wrecking bar; 

(8) One 48-inch crowbar with pinch point; 

(9) Two pair heavy duty work gloves; 

(10) Two pair OSHA approved safety glasses; 
and 

(11) Two OSHA approved safety helmets. 



Statutory Authority 
1438-165(9). 



G.S. 13IE-I57(a); 



.1003 OTHER EQUIPMENT 

(a) Ambulances for which permits are issued 
as Category I, II, or III must have at least the 
following: 

(1) One operational flashlight; 

(2) A two and one-half pound fire extin- 
guisher which must be a dry chemical or 
halogen, all-purpose type with a pressure 
gauge and approved by Underwriters La- 



NORTH CAROLINA REGISTER 



387 



PROPOSED RULES 



boratories and U.S. Department of 
Transportation and must be mounted in 
a quick-release bracket; 

(3) "No Smoking" signs placed in cab/cabin 
and patient compartments; and 

(4) Electric lights to illuminate the patient 
compartment which are designed and lo- 
cated so that no glare is reflected into the 
dnvers eyes or line of vision. 

(b) Institutions/organizations which operate 
Category IV ambulances within the State of 
North Carolina shall be defmed as Air Taxi Op- 
erators under Part 135 of Title XIV or Part 91- 
of the Federal Aviation Administration's Rules 
goverrung air operations and as such must hold 
a current certificate under these rules. In addi- 
tion to the equipment required under this certif- 
ication: 

(1) All Category IV ambulances must be 
equipped with an internal voice commu- 
nication system to allow for communi- 
cation between the medical crew and the 
flight crew; and 

(2) ,'\11 rotary wing Categor>' IV ambulances 
must be equipp>ed with: 

(A) An external public address system; 

(B) A remote control external search light; 
and 

(C) A light which illuminates the tail rotor. 

(c) Institutions organizations which operate 
Categorv' IV ambulances must submit to the Di- 
vision of Facihty Senices, Office of Emergency 
Medical Services: 

( 1 ) Copy of current Federal Aviation Admin- 
istration Part 135 or 91 Certificate. A 
copy of this document is available for re- 
view at the Division of Facility Services, 
Office of Emergency Medical Services, lo- 
cated at 701 Barbour Drive, Raleigh, 
North Carolina or copies may be obtained 
by contacting the Sup)erintendent of Doc- 
uments, L .S. Government Printing Office, 
Washmgton, D.C. 20402; and 

(2) Documentation that operation is coordi- 
nated with the local EMS system. 

(d) In addition to that required in Paragraph 
(b) of this Rule, Category' IV ambulances ap- 
proved under Rule .08dl(b)(4)(B) of these rules 
must be equipped with: A two-way voice radio 
licensed by the Federal Commumcations Com- 
mission capable of operation on any frequency 
required in the Public Safety Radio Service or 
Special Emergency Radio Service to allow com- 
mumcations on an as needed basis with public 
safety agencies such as fire departments, pwhce 
departments, ambulance and rescue units, hospi- 
tals and local government agencies. 



(e) In addition to that required in Paragraph 
(a) of this Rule, Category V ambulances must 
be equipped with: 

(1) Two floatable operational flashlights; 

(2) Two five pound fire extinguishers which 
must be a dry chemical, all-purpose type 
with a pressure gauge and approved by 
Underwriters Laboratories and U.S. De- 
partment of Transportation and must be 
mounted in a quick-release bracket; 

(3) Lighted compass; 

(4) Radio navigational aids as ADF (auto- 
matic directional finder) or LORAN-C, 
navigational radar, or other comparable 
radio equipment suited for water naviga- 
tion; and 

(5) Marine radio. 

(f) Institutions/organizations which operate 
Category V ambulances with the State of North 
Carolina must comply with all provisions of 
Chapter 75A Article 1 (Boating Safety Act) of 
the North Carolina General Statutes including 
all rules established by the North Carolina Wild- 
life Resources Commission under the authonty 
of these statutes. 



Statutory Authority 

I43B-I65(9). 



G.S. I3IE-I57(a): 



.1004 WEAPONS AND EXPLOSIVES 
FORBIDDEN 

(a) Weapons and explosives shall not be worn 
or earned aboard an ambulance vehicle within 
the State of North Carolina when such ambu- 
lance vehicle is operatmg in any patient transport 
capacity or is available for such transf>ort func- 
tion. 

(b) This Rule shall apply whether or not such 
weapons and explosives are concealed or visible. 

(c) This Rule shall not apply to duly appointed 
law enforcement officers who are serving in an 
authorized law enforcement capacity while a 
passenger, occupant or attendant on an ambu- 
lance vehicle. 

Statutory Authority G.S. I3IE-I57(a): 
I43B-I65(9). 

SECTION .1 100 - COMMLNICATIONS 

.1 101 PUBLIC ACCESS TO AMBLLANCE 
SERVICE 

(a) All ambulance services shall utilize the 
public dial telephone network as the primar>' 
method for the public to request ambulance as- 
sistance. Within an emergency ambulance ser- 
vice area there shall exist a well-publicized 
telephone number for the public to call request- 
ing emergency ambulance service. 



iS8 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(b) Calls for emergency ambulance assistance 
shall be answered by experienced telecommu- 
mcators with training in the management of calls 
for medical assistance. The point of public con- 
tact for answering calls for emergency medical 
ambulance assistance shall be operational and 
staffed on a continuous 24 hour per day basis. 

(c) The telephone access point for emergency 
ambulance assistance shall be direct to emergency 
assistance, and shall not require any caller to be 
instructed to hang up the telephone and dial an- 
other telephone number. The person calling for 
emergency assistance shall never be required to 
talk with more than two persons to request 
emergency ambulance assistance. 



Statutory Authority 
143-509(4). 



G.S. I31E-I57(a); 



.1102 DISP.\TCH 

."Ml EMS providers shall operate an organized 
system of communications that provides for the 
dispatch of the closest, most appropriate emer- 
gency medical response unit to any given caller's 
request for assistance. The dispatch of all am- 
bulances shall be in accordance with an official 
written county plan for the management of 
emergency ambulances. 



Statutory Authority 
145-509(4). 



G.S. I31E-I57(aj: 



.1103 EQLIPVIENT 

Each ambulance shall be equipped with a two- 
way radio capable of establishing radio commu- 
nications from within the ambulance service area 
of the county in which the ambulance is based 
to the county designated dispatch coordination 
center in that county and to the emergency de- 
partment of the hospital(s) to which patients are 
routinely transported. The radio shall be licensed 
bv the Federal Communications Commission 
(FCC). 



Statutory Authority 
143-509(4). 



G.S. 13IE-I57(a): 



.1104 LICENSE REQLIRED 

Copies of the FCC radio license shall be on file 
at the base of operations of the emergency am- 
bulance service, and displayed at the control 
point for the two-wav radio in accordance with 
FCC Rules Part 90.113. 

Statutory Authority G.S. I3IE-I57(al: 
143-509(4). 

SECTION .1200 - AMBLLANCE PROVIDERS 



.1201 PERMIT TO OPERATE AMBULANCE 
SERVICE 

(a) All EMS providers in North Carolina must 
receive a permit to operate an ambulance service, 
issued by the Office of Emergency Medical Ser- 
vices. In order to be issued a permit, the pro- 
vider must: 

(1) Document compliance with Sections 
.0900, .1000, .1100, .1200, .1300, .1400, 
and . 1 500 of this Subchapter pertaining to 
vehicles, base facilities, p>ersormel, and 
staffing; 

(2) Identily a sj)ecific ambulance service area 
to include the number and location of 
ambulance station headquarters and sub- 
stations and mechanism of public access 
and dispatch; 

(3) Identify the level of care that will be pro- 
vided to the ambulance service area; 

(4) Document the vehicles to be used in pro- 
viding the service (including Vehicle 
Identification Number) and identify the 
level of care for which each will be 
equipped; 

(5) Complete any reports and surveys required 
by the Office of Emergency Medical Ser- 
vices; and 

(6) Present documentation of approved fran- 
chise to operate an ambulance ser%'ice 
within the county of proposed operation 
where applicable. 

(b) Permits to operate an ambulance service 
shall be valid for a period not to exceed five 
years. Renewal may be accomplished by sub- 
mission of the information required in this Rule 
and inspection by the Office of Emergency Med- 
ical Services. 

(c) A permit to operate an ambulance service 
must be prominently displayed in a public place 
at the primary base of operation of the provider. 

(d) The Office of Emergency Medical Services 
may issue a temf)orary permit to operate an am- 
bulance service for providers not meeting the re- 
quired standards for a period not to exceed 60 
days, when it is in the best interest of the public. 

Statutory Authority G.S. 1438-/65(9). 

SECTION .1300 - STAFFING AND PERSONNEL 
REQUIREMENTS 

.1301 STAFFING FOR CATEGORY I 
AMBULANCES 

(a) Category I and V ambulances must be 
staffed, at a minimum, by one Ambulance At- 
tendant and one EMT while transporting a pa- 
tient. 



NORTH CAROLINA REGISTER 



589 



PROPOSED RULES 



(b) Categorv' III ambulances must be staffed, 
at a mimmum, with one .Ambulance Attendant 
responsible for vehjcle operations, and one other 
appropnately licensed or certified individual to 
be responsible for patient care, whose level of li- 
censure or certification is to be deterrruned by the 
medical director of the program. 

(c) Category' IV ambulances must be staffed, 
at a mirumum, with one medical crew member, 
in addition to the flight crew. Tlie medical di- 
rector shall assure that the level of trairung and 
number of medical crew members assigned to a 
specific mission is appropriate ta pro\ide the ne- 
cessary patient care for that mission. 

Statutory Authority G.S. J3JE-/58. 

SECTION .1400 - TRAINING WD 
PERFORMANCE OF PERSONNEL 

.1401 CRITERIA FOR APPROVED 
TEACHING INSTITUTIONS 

.•\n approved Teaching Institution as defined in 
Rule .0809 of this Subchapter shall provide, at a 
minimum, the foUowmg: 

( 1 ) Emergency medical services training courses 
following guidelines established by the 
Commission; 

(2) .Adequate number of instructors, with a 
muumum of one instructor for each ten 
students dunng practical skills mstruction; 

(3) Equipment of the type and quantity needed 
to train students in the required practical 
skills: 

(4) Transfer of information necessary to allow 
students to sit for the appropriate state cer- 
tification examination(s) to the Office of 
Emergency .Medical Services; and 

(5) Attendance records of students for periodic 
review by the Office of Emergency .Medical 
Services. 

Statutory Authority G.S. 13 JE- /59(b). 

.1402 CRITERIA FOR QLALIFIED EMT 
INSTRUCTOR 

.A qualified E.MT Instructor as defmed in Rule 
.0808 of this Subchapter shall meet the foUowing 
criteria: 
( 1 ) Recogxution from the Office of Emergency 
.Medical Services that he meets the foUowmg 
Standards of the EMT Instructor; Coordi- 
nator Recognition Program: 
(a) Current North CaroUna certification as an 
EMT, EMT-defibnllation technician, 
EMT-intermediate, EMT-advanced mter- 
mediate, or E.MT-paramedic; 



(b) Two years experience within the last five 
years of direct patient contact in critical 
or emergency care; 

(c) Current certification as an American Heart 
Assoaation or American Red Cross car- 
diopulmonary' resuscitation (CPR) in- 
structor; 

(d) Successful completion of the U.S. De- 
partment of Transportation's, E.MT In- 
structor Course or equivalent; 

(e) High school diploma or General Educa- 
tion Development certificate; 

(f) A lead or assistant instructor for six basic 
rescuer CPR courses within the last three 
years: and 

(g) Expenence as an instructor for at least 
three basic E.MT courses or complete 
praaice teaching in one basic EMT 
course under the supervision of an expe- 
rienced EMT instructor. 

(2) Annually attends an EMT Evaluator and 
Instructor Coordinator Workshop offered 
by the Office of Emergency Medical Ser- 
vices. 

Statutory Authority G.S. I3IE-I59(b). 

.1403 TRAINING PROGRAMS 

A traiiung program intended to qualify person- 
nel as Ambulance Attendants or Emergency 
Medical Technicians must be approved by the 
Office of Emergency Medical Services foOowing 
guidelines established by the Commission and 
offered by an approved teaching institution. 

Statutory Authority G.S. I3IE-I59(b). 

.1404 AEROMEDICAL FLIGHT AND 
MEDICAL CREW MEMBERS 

(a) All flight crew members who operate as the 
pilot m command and who fly rotary wmg air- 
craft as air ambulances must meet, at a mini- 
mum, the following criteria: 

(1) 2.000 hours hehcopter flight time; 

(2) Commeraal rotocraft certificate; 

(3) Instrument helicopter ratmg; 

(4) Ten hours additional flight training when 
making a transition from single to twm 
engine aircraft; 

(5) Five hours additional flight training when 
making a transition from one model air- 
craft to another; 

(6) Ten hours flight time orientation for new 
pilots if unfamiliar with the program ser- 
vice area including night flights; and 

(7) Five hours flight time orientation for new 
pilots if familiar with the program service 
area including night flights. 



590 



NORTH CAROUNA REGISTER 



PROPOSED RULES 



(b) .•Ml flight crew members and medical crew 
members, includmg speaalty teams must meet, 
at a rmnimum. the following critena: 

( 1 ) Fly an average of at least five missions per 
month per six month period or complete 
refresher training m aircraft safety every 
six months; and 

(2) Complete refresher training in aircraft saf- 
ety on an annual basis. 

Siaiutory Authority G.S. 13IE-I59(b). 

.1405 AM BL LANCE .ATTENDANT 
PERFORMANCE 

.Vmbulance attendants trained in approved 
trairung programs and certified by the Office of 
Emergency Medical Services may assist the 
emergency medical technician in performing any 
of the following procedures if allowed by the 
County Emergency Medical Services System in 
which they function: 

(1) Patient assessment: 

(2) Basic life support techniques in accordance 
with the American Heart Association or 
American Red Cross including airway man- 
agement and cardiopulmonary resuscitation; 

(3) Hemorrhage control; 

(4) Oxygen administration; 

(5) Treatment for shock: 

(6) Bandaging and dressing soft tissue injuries; 

(7) SpUnting fractures and dislocations; 

(8) Treatment of injunes to the skull, spine, 
and chest; 

(9) .Assisting in normal and abnormal child- 
buth, 

(TO) Liftmg and moving patients for transfer to 
a medical facility; 

(11) Treatment of injuries as a result of expo- 
sure to heat and cold; 

( 12) Treatment of bums; and 

(13) Providmg of basic life support for medical 
emergencies. 

Statutory^ Authority G.S. I3IE-I59(b). 

.1406 EMERGENCY MEDICAL TECHNICIAN 
PERFORMANCE 

Emergency Medical Technicians tramed in ap- 
pro\ed training programs and certified by the 
Office of Emergency Medical Services may per- 
form any of the followmg procedures if allowed 
b\ the County Emergency Medical Services Sys- 
tem in which they function: 

(1) Patient assessment; 

(2) Basic life support techniques in accordance 
with the .American Heart Association or 
Amencan Red Cross including airway man- 
agement and cardiopulmonary resuscitation; 



(3) Oxygen administration; 

(4) Hemorrhage control; 

(5) Treatment for shock; 

(6) Bandaging and dressing soft tissue injuries; 

(7) Application of military anti- shock trousers; 

(8) Splinting fractures and dislocations; 

(9) Treatment of injuries to the head, face, eye, 
neck, and spine; 

(10) Treatment of injuries to the chest, abdo- 
men and genitalia; 

(11) Provision of basic life support for medical 
injuries; 

(12) Assisting in normal and abnormal child- 
births; 

(13) Treatment of injuries as a result of expo- 
sure to heat and cold; 

(14) Treatment of bums; 

( 1 5) Lifting and moving patients for transfer to 
a medical facility; and 

(16) Extrication of patients from confined ar- 
eas. 

Statutory Authority G.S. I3IE-I59(b). 

SECTION .1500 - CERTIFICATION 

REQLIREMENTS FOR BASIC SUPPORT 

PERSONNEL 

.1501 CERTIFICATION REQLIREMENTS: 
AMBULANCE ATTENDANT 

(a) To become certified as an /Vmbulance .At- 
tendant, a person must successfuUy complete ei- 
ther of the following options: 
OPTION I 

( 1 ) Be at least 18 years of age; 

(2) Pass a physical examination performed by 
a physician documenting the ability to 
function as an Ambulance .Attendant; 

(3) Successfully complete, within one year 
prior to application, an Ambulance At- 
tendant training course approved by the 
Office of Emergency Medical Services, 
following guidelines established by the 
Commission. When training was com- 
pleted over one year prior to application, 
a person must submit evidence of com- 
pletion of pertinent refresher training m 
emergency medicine taken in the past year 
for approval by the Office of Emergency 
Medical Services; 

(4) Pass a basic life supix)rt practical exam- 
mation administered by the Office of 
Emergency Medical Services; and 

(5) Pass either an Ambulance Attendant 
written examination, or an oral examina- 
tion at the option of the applicant, ad- 
ministered by the Office of Emergency 
Medical Services; or 

OPTION II 



NORTH CAROLINA REGISTER 



391 



PROPOSED RULES 



( 1 1 Be at least 1 8 years of age; 

(2) Pass a physical examination perfonned by 
a physician documenting the ability to 
function as an Ambulance Attendant; 

(3) Successfully complete, within one year 
pnor to application, an Emergency Med- 
ical Techiucian training course approved 
by the Office of Emergency Medical Ser- 
vices, followmg guidelmes established by 
the Commission. When training was 
completed over one year prior to applica- 
tion, a person must submit evidence of 
completion of pertinent refresher traming 
in emergency medicine taken in the past 
year for approval by the Office of Emer- 
gency Medical Services; 

(4) Pass a basic Ufe support practical exam- 
ination administered by the Office of 
Emergency .Medical Services; and 

(5) Complete an Emergency Medical Techni- 
cian wntten examination admmistered by 
the Office of Emergency Medical Services 
and achieve a minimum score of 55 per- 
cent. 

(b) Persons holding current certification 
equivalent to an .Ambulance Attendant with an- 
other state where the trairung and certification 
requirements have been approved for reciprocity 
by the OtTice of Emergency Medical Serv'ices may 
become certified by: 

(1) Presenting e\idence of such certification 
for verification by the Office of Emer- 
gency Medical Services; and 

(2) Meeting the cnteria specified m Para- 
graphs (a)(1) and (a)(2), of this Rule. 

(c) Certification obtamed through reciprocity 
shall be valid for a penod not to exceed the 
length of the current certification or a f>eriod not 
to exceed two years whichever is shorter. No 
certification shall be valid for a penod exceedmg 
two years. Persons who live m a state that bor- 
ders North CaroUna and are currently affiliated 
with an ambulance pro\ider m North Carolma 
may continue to obtain a North Carolina certif- 
ication tlirough reciprocity if they continue to 
meet the recertification requirements m the state 
in which they reside. Persons who live in North 
Carolina and are currently certified in another 
state that borders North Carolina may continue 
to obtain a North Carolina certification through 
reciprocity if they contmue to meet the recertif- 
ication requirements in the state in which they 
are certified. Persons who were pre\iously certi- 
fied m North Carolina and are currently certified 
in another state or with the National Registn of 
Emergency Medical Techmcians, must present 



evidence of pertinent refresher training and skill 
evaluation pnor to becoming certified through 
reciprocity. 

(d) To become recertified as an Ambulance 
Attendant a person must successfully complete 
either of the following options; 
OPTION I 

(1) A physical examination performed by a 
physician documenting the ability to 
function as an Ambulance Attendant; 

(2) An .Ambulance Attendant refresher train- 
ing program, approved by the Office of 
Emergency Malical Services, followmg 
guidelines established by the Commission; 

(3) A basic life support practical examination 
administered by the Office of Emergency 
Medical Services; or 

OPTION II 

(1) A physical examination performed by a 
physician documenting the ability to 
function as an Ambulance Attendant; 

(2) A continuing education program taught 
or coordinated by an approved EMT In- 
structor, following guidelmes established 
by the Commission; and 

(3) A basic life support skill evaluation(5) 
conducted under the direction of the ap- 
proved EMT Instructor assessing the 
ability to perform the skills of an Ambu- 
lance Attendant, approved by the Office 
of Emergency Medical Services, following 
guidelmes established by the Commission. 

Statutory Authority G.S. l3IE-!59(bj. 

.1502 CERTIFICATION REQUIREMENTS: 

EMERGENCY MEDICAL TECHNICIAN 

(a) To become certified as an Emergency 
.Medical Technician, a person shall meet the fol- 
lowing criteria: 

(1) Be at least 18 years of age; 

(2) Pass a physical exammation performed by 
a physician documenting the ability to 
function as an Emergency Medical Tech- 
nician; 

(3) Successfully complete, within one year 
pnor to application, an Emergency .Med- 
ical Technician training course approved 
by the Office of Emergency Medical Ser- 
vices, following guidelines established by 
the Commission. When training was 
completed over one year prior to applica- 
tion, a person must submit evidence of 
completion of pertment refresher training 
m emergency medicme taken in the past 
year for approval by the Office of Emer- 
gency Medical Services; 



392 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(4) Pass a basic life support practical exam- 
ination administered by the Office of 
Emergency Medical Services; and 

(5) Pass an Emergency Medical Technician 
written examination administered by the 
Office of Emergency Medical Services. 

(b) Persons holding current certification 
equivalent to an Emergency Medical Technician 
with the National Registry of Emergency Med- 
ical Technicians or in another state where the 
training and certification requirements have been 
approved for reciprocity by the Office of Emer- 
gency Medical Services may become certified by: 

(1) Presenting evidence of such certification 
for verification by the Office of Emer- 
gency Medical Services; and 

(2) Meeting the criteria specified in Para- 
graphs (a)(1) and (a)(2), of this Rule. 

(c) Certification obtained through reciprocity 
shall be valid for a period not to exceed the 
length of the current certification or a period not 
to exceed two years whichever is shorter. No 
certification shall be valid for a jjeriod exceeding 
two years. Persons who live in a state that bor- 
ders North Carolina and are currently affiliated 
with an ambulance provider in North Carolina 
may continue to obtain a North Carolina certif- 
ication through reciprocity if they continue to 
meet the recertification requirements in the state 
in which they reside. Persons who live in North 
Carolina arnJ arc currently certified in another 
state that borders North Carolina may continue 
to obtam a North Carolina certification through 
reaprocity if they continue to meet the recertif- 
ication requirements in the state in which they 
are certified. Persons who were previously certi- 
fied in North Carolina and are currently certified 
in another state or with the National Registry of 
Emergency Medical Technicians, must present 
evidence of pertinent refresher training and skill 
evaluation prior to becoming certified through 
reciprocity. 

(d) To become recertified as an Emergency 
Medical Technician a person must successfully 
complete either of the following options: 

OPTION I 

( 1 ) A physical examination performed by a 
physician documenting the ability to 
function as an Emergency Medical Tech- 
nician; 

(2) .\n Emergency Medical Technician re- 
fresher training program approved by the 
Office of Emergency .Medical Services, 
following guidelines established by the 
Commission; 

(3) A basic life support practical examination 
administered by the Office of Emergency 
Medical Services; or 



OPTION II 

(1) A physical examination performed by a 
physician documentmg the ability to 
function as an Emergency Medical Tech- 
nician; 

(2) A continuing education program taught 
or coordinated by an approved EMT In- 
structor, following guidelines established 
by the Commission; and 

(3) A basic life support skill evaluation(s) 
conducted under the direction of the ap- 
proved EMT Instructor assessing the 
ability to perform the skills of an Emer- 
gency Medical Technician, approved by 
the Office of Emergency Medical Services, 
following guidelines established by the 
Commission. 

Statutory Authority G.S. l3IE-IS9(b). 

SECTION .1600 - ADMINISTRATION 

.1601 PERMIT/CERTIFICATION DENIAL: 
SUSPENSION: OR REVOCATION 

(a) The Office of Emergency Medical Services 
may deny, suspend, or revoke the permit of an 
ambulance service or of a specific vehicle for any 
of the following reasons: 

(1) Failure to comply with the requirements 
of Section .0900 of this Subchapter; 

(2) Obtaining a permit through fraud or mis- 
representation; and 

(3) Failure to provide emergency medical care 
to the defmed ambulance ser% ice area m a 
timely and professional manner. 

(b) The Office of Emergency .Medical Services 
may deny, suspend, or revoke the certification of 
a field technician for any of the following reasons: 

(1) Failure to comply with the applicable 
performance and certification require- 
ments as found in Section .0800 of this 
Subchapter; 

(2) Obtaining or attempting to obtain certif- 
ication or recertification through fraud or 
misrepresentation; 

(3) Aiding a person in obtaining or attempting 
to obtain certification or recertification 
through fraud or misrepresentation; 

(4) Failure to competently perform the skills 
or procedures enumerated in Section 
.1400 of this Subchapter; 

(5) Performance of a skill or procedure which 
is not within the scope and responsibility 
of the certificate holder; 

(6) Performance of a skill or procedure that 
is detrimental to the health and safety of 
a patient; 

(7) Any felony conviction; 



NORTH CAROLINA REGISTER 



393 



PROPOSED RULES 



(S) A rrusdemc 



(9) 



conviction of the use, 
possession, < nbution of illegal drugs 

within the p^ ..e years; and 

Conviction of driving while impaired 
within the past five years. 



Statutory Authority G.S. I3IE-I59(a). 

.1602 PROCEDl RES FOR DENIAL: 
SLSPENSION: REVOCATION 

Denial, suspension, or revocation of a permit 
or certification shall foUow the rules regardmg 
contested cases found in G.S. 150B. 

Statutory Authority G.S. I3IE-I59(a). 

.1603 APPLICATION PROCEDURES: 
REQUIRED FORMS 

(a) ,\11 applications for permits, certification, 
or recertification must be filed with the Office of 
Emergency Medical Services on the appropnate 
forms. 

(bi At a minimum, the following forms are re- 
quired for application: 

Certification .Application Form; 
.Medical Certification Form; 
(31 EMT Recertification Continuing Educa- 
tion Verification Form; and 
(4) .Air .Ambulance Report Form. 
(c) E-MS pro\iders shall complete all forms, 
surveys, and requests for data, as required by the 
Office of Emergency .Medical Services. 

Statutory Authority G.S. I3IE-I59(a). 

****************** 



(1) 



No 



otice is hereby gnen in accordance with G.S. 
1 508- 1 2 that the Division of Facility Services in- 
tends to amend rule(s) cited as 10 SCAC 3S 
.OIOS ■ .0/09. .0207 - .0211. .0213 - .02/4, .030^ 

- .0308. .0407 - .0408. .0506 - .0509, .06/4 - .06/9, 
.0~06 - .0^0^. .0806 - .0808. .090/ ■ .0902, ./OO/ 

- ./004. ./006: adopt ruleis) cited as /O SCAC 
3S .0903 - .0904; and repeal ruleis I cited as 10 
.\CAC 3S .02/2. 

I he proposed effective date of this action is De- 
cember /. /989. 



Th 



he public hearing will be conducted at 9:30 
a.m. on September /5, /9S9 at Hearing Room, 
Division of Facilitv Services, 70/ Barbour Drive, 
Raleigh. \.C. 2~603. 



Cc 



omment Procedures: .Any interested person 
may present comments in writing at least three 



days prior to or at the hearing or orally at the 
hearing for a maximum of ten minutes. Any per- 
son may request information by writing or calling 
Lynda McDaniel. Division of Facilitv Services, 
70/ Barbour Drive, Raleigh, ,V.C. 27603. (9/9 J 
733-2342. 

SUBCHAPTER 3S - CERTIFICATION OF 
CARDIAC REHABILITATION PROGR.AMS 

SECTION .0100 - GENERAL INFORMATION: 
ADMINISTRATION 

.0108 DEFINtTFONS - 

The foUowing definitions will apply throughout 
this Subchapter: 

(1) "Cardiac Rehabilitation Program" means a 
program certified under .Article 8 of Chapter 
13 IE of the North Carolina General Statutes 
for the delivery of cardiac rehabilitation ser- 
vices to clients, in environments other than 
hospitals and includes, but shall not be lim- 
ited to: coordinated, physician-directed, in- 
dividualized programs of therapeutic activity 
and adaptation Ufestvle modifications which 
are designed to assist the cardiac patient m 
attaining the highest rehabilitative potential; 

(2) "Certification" means the issuance of a 
certificate by the Department upon determi- 
nation that cardiac rehabilitation services 
offered at a given program site moot are in 
substantial compliance with aU cardiac re- 
habilitation program rules contained m this 
Subchapter and the provisions of G.S. 
Chapter 13 IE, .Article 8; 

(3) "Department" means the Department of 
Human Resources; 

(4) "Program Director" means the person who 
supervises the staff of a certified cardiac re- 
habilitation program and directs aU facets of 
the program; 

(5) "Site" means the facility in which the car- 
diac rehabilitation program is held; 

(6) 'Cardiac therapy session" means that pe- 
nod of time that is staff directed and consists 
of specific warm-up. stimulus phase, and 
cool-down activities; 

d) Regular follow-up mtervals - three, six. 12 

months; 
(8) "Division" means the Division of Facihtv 

Services. 

Statutory Authority G.S. /3/E-/69. 

.0109 POLICIES AND PROCEDURES 

The program director of each cardiac rehabili- 
tation program shall assure wntten poliaes and 
procedures which are available and implemented 



.^94 



,\ORTH CAROLIN.i REGISTER 



PROPOSED RULES 



by the staff. These policies and procedures shall 
cover at least the following areas: 

( 1 ) admission of patients; 

(2) patient assessment; prescription and ther- 
apy; 

(3) diocharpo ef pati e nt; patient foUow-up; 

(4) poet dibLnorgo, follow up aB4 ovoluation; 
patient discharge; 

(5) maintenance and retention of medical re- 
cords; aH4 individual oordiao patient r e ha 
bUitation plans; 

(6) orientation of all program personnel; 

(7) phyoioian oors'iooo 8«4 utiliiiatio « ef pa- 
tiont'o private physician; personnel records 
which include verification of credentials; 

(8) proouromont »f oupplioo afi4 oquipmont; 
communication with patient(s) 
referral /personal phvsician(s); 

(9) procedures for recording and reviewing of 
all incidents and accidents; 

f+0^ ooopo ef oon'iooo provided; 

(10) f4-14 confidentiality of medical record in- 
formation; 

(1 l) f4-3^ emergency procedures. 

f44^ participation m uniform 4at« tabulation 
a»4 coUoction oyGtomo; aH4 

f4-4^ &t«ff dovolopmont. including, btrt- Ret Im- 
)4e4 ^7 a roquifoment \k*fA eA f^e^ momboro 
attend at least ene e xerois e ooooion vvooldy. 

Statutory Authority G.S. I3IE-I69. 

SECTION .0200 - CERTIFICATION 

.0207 CERTIFICATION REQUIRED 

(a) For a cardiac rehabilitation program to be 
certified under G.S. Chapter 13 IE, Article 8, a 
cardiac rehabilitation program must be issued a 
certificate by the Department when the d e part 
mont Division determines that the program 
complies with the provisions of G.S. Chapter 
13 IE, Article 8, and is in substantial compliance 
with the rules contained in this Subchapter. 

(b) A certificate issued to a specific cardiac re- 
habilitation program by the department is not 
transferable or assignable, except with prior writ- 
ten approval of the department. A currently 
valid certificate must also be pxjsted in a con- 
spicuous place on the certified premises. 

(c) A new certification shall be required when 
there is a change of either the program director 
or medical director. The necessity and tvF>e of 
re\iew shall be at the discretion of the Division. 

Statutory Authority G.S. I3IE-I69. 

.0208 TYPES OF CERTIFICATION 



Two types of certification are issued to cardiac 
rehabilitation programs. They are as follows: 

(1) Provisional Certification. 
(d) A provisional certification may be ex- 
tended for up to three months when a new 
program begins and when extreme cir- 
cumstances occur to restrict the develop- 
ment of the program. The program must 
apply in writing to the Division for an 
extension. 

Statutory Authority G.S. I3IE-I69. 

.0209 APPLICATION 

(a) An application for certification shall be 
submitted to the Department prior to a certificate 
being issued. 

(b) An application shall be submitted prior to 
the occurrence of any of the following circum- 
stances: 

(1) Initial oortifioation (now proRram); Provi- 
sional certification of a new program; 

(2) Change of premises (initial certification of 
new premises or addition of new site) ; 

(3) Change of ownership (initial certification 
of new owner), program director or med- 
ical director; and 

(4) Recertification. 

following: 

(-i-f nam e aR4 addroos ef applicant (owner); 
f^ name e( t^ program (e whioh oortifioate 

{^ addrooD ef t^ 6tt« at whioh t^ program 
ift te b» oonduotod; 

f4^ nam e &i program direotor; 

f^ name e^ medical director; 

^ t^ name and pnnoipal buDineoo address 
»f eaei» aH4 aU offioors aA4 dirootoro ae 
weti as t^ name aH4 principal busineos 
addreoo el ea«^ partner er stoolcholder 
owning directly ef indirectly -W perc e nt 
ep more ef ttie otoolc, tf appropriate; aitd 

f?) &uek other dooumonto ef informati eft et% 
may b« required by t^ department m 4e- 
termining whether te grant a cortifioato. 

Statutory Authority G.S. I3IE-I69. 

.0210 INSPECTION 

(a) Any cardiac rehabilitation program apply- 
ing for certification shall be inspected by repre- 
sentatives of the department Division prior to the 
issuance of a certificate. 

(b) Any cardiac rehabilitation program certified 
by the Department may be inspected by author- 
ized representatives of the d e partm e nt Division 
at any time during the program's business hours. 



NORTH CAROLINA REGISTER 



395 



PROPOSED RULES 



On-site inspections shall be conducted as neces- 
5ar>' to certify compliance or continued compli- 
ar .c with certification requirements. Inspections 
n, be unannounced TTie purpose of any in- 
sp ction wiU be explamed or summarized with 
th. program director. 

(c) The program director shall provide and 
make available to representatives of the depart 
mont ouch fmancial. otatiotioo] aft4 othor rooordo 
a*- Dnision records deemed necessary to demon- 
strate compbance with this Subchapter. 

(d) Routme mspections shall be conducted by 
one or more review team consultants with spe- 
cialities in areas to be evaluated. 

(e) Following completion of an inspection, an 
exit-conlerence shall be conducted with one or 
more representatives of the program's manage- 
ment. An oral summary of the fmdings shall be 
presented at the exit-conference. The doport 
mont Division shall provide the program director 
with a wntten report of the fmdings within 20 
workmg days following the mspection. The 
program director shall have ten working days 
from the receipt of the report to respond with a 
plan or report which describes the steps taken to 
remedy any observed deviations from certif- 
ication rules contained in this Subchapter. 

Siatuton. Authority G.S. 13IE-169- 

.021 1 REVIEW 1 E.\M: REVIEW PROCESS 

(a) The review team must should include per- 
sons from existmg certified programs with spe- 
cialities m program areas to be mspected, (e.g., 
physiaan, program director, vocational rehabili- 
tation counselor, exercise specialist or coordina- 
tor, dietitian nutntionist, registered nurse, 
psychologist, busmess manager and any other 
appropriate consultants). Persons subject to oc- 
cipational hcensmg (physician, psychiatrist, etc.) 
r ust have a current, valid North Carolina license 
or registration. 

(b) The team of consultants will include staff 
from existmg certified cardiac rehabilitation pro- 
grams. The vocational rehabilitation counselor 
wiU be reviewed by a vocational rehabilitation 
counselor servmg m a certified cardiac rehabili- 
tation program or another person from the North 
Carolma Dn'ision of \'ocational Rehabilitation. 
.-Ml persons assigned to review teams are author- 
ized representatives of the Department when en- 
gaged in an inspection of a cardiac rehabilitation 
program scheduled in accordance with Rule 

0210 of this Subchapter. 

(c) If the service of a phvsinan reviewer cannot 
be obtained to participate m a program re\iew, 
the Dnision review coordmator will make ap- 



propnate adjustments in review team composi- 
tion. 

(d) The review team will observe the program 
in operation and interview staff members to as- 
sess the operation of the program. 

(e) Each re\iew consuhant will submit their 
workmg copy of the review form to the review- 
coordinator at the completion of the review. The 
review coordmator will summarize the fmdmgs 
and report m wntmg to the program withm 20 
worlang davs. 

Statutory Authority G.S. I31E-169. 

.0212 TEAM PROCESS (REPEALED) 

Statutory Authority G.S. I5IE-I69. 

.0213 ADVERSE ACTION 

If a program is found in significant noncompli- 
ance with the rules contained m this Subchapter 
and G.S. Chapter 131E, Article 8, the doport 
mont Division shall either issue a provisional 
certification, deny a request for full certification, 
suspend a program's certification, or revoke the 
program's certification. Compliance failure h* 
Vwr» ef moro ©f t}*© following oholl be which 
jeopardizes the health, safety and welfare of the 
patient(s). and remains uncorrected as specified 
bv the Division, mav be sutfiaent cause for tjie 
demal or revocation of certification. 
f4-> three »* more diociplinoo 4» »e4- have f*^ 

uioito orodentials a* §t«ff momboro; 
fS-> maior violationo &i oofoty ooncideration m- 
ciuding k«l* %i oxygon afl4 unavailability ef 
B» adequately otocUod oraoh eea^ 
f44 tw» &f moro intor^ontiono miooing: 
(4^ inadequate numbero ef staff poroormel te' 

onouro i4*e sftfe deliverj i ' »f oonioeo; 
(4^ inadequate team prooooo: 
f4^ inadequate aoooDoment proooduroo; 
(-J+ inadequate equipment Bf facilitioo: ef 
fS^ non participation iftt^ admmiotrati> o date 
tabulation oyctem. 

Statutory Authority G.S. I3IE-I69. 

.0214 PROCEDURE FOR APPEAL 

A cardiac rehabilitation program may appeal 
any decision of the departm e nt Division to deny, 
revoke, susp>end, or amend a certificate by mak- 
mg such an appeal m accordance with G4<- 
Chaptor 44aA G^ 150B and 10 NCAC IB 
.0200. 

Statutory- Authority G.S. 1 31 E- 169. 

SECTION .0300 - PERSONNEL 



396 



^ORTH CAROLINA REGISTER 



PROPOSED RULES 



.0307 COMPOSITION OF STAFF 

The following personnel must be on the staff 
of a certified cardiac rehabilitation program: Tlie 
program staff must include a program director, 
medical director, dietitian nutntionist, 

psvcholo.gist psvchiatnst, vocational rehabili- 
tation counselor, exercise specialist coordmator 
and patient educator. One staff member shall 
not have primary responsibility for more than 
two staff positions. 

(I) Staff Positions: 

(a) f4^ Program director serves as the admin- 

istrator of the certified program, super- 
vises the staff and directs all facets of the 
total program. 

(b) f^ .Medical director is the consultant on 

all medical aspects of the program and is 
responsible for the medical supervision of 
all testing, treatments and therapy pro- 
grams of patients in addition to develop- 
ing emergency procedures and attending 
to the equipment, medication, and ade- 
quacy of personnel, includmg the physi- 
cians. This person is also the liaison with 
the medical community. 

(c) (4^ Exercise specialist coordinator is re- 

sponsible for designing and supervising 
the exercise programs m consultation with 
the medical director. Duties also include 
implementation of the exercise pre- 
scription. Daily heart rate, attendance 
records and other information are col- 
lected and maintained on a regular basis 
by this staff member. 

(d) f4^ Exorcioo tochnologiot worko under irm 

direction ef tk« m e dical dir e ctor a»4 i« 
rooponGible ^ (k« adminiotration ef ^ 
graded on e roioo t«^ including 1^ opera 
t+eft e^ y^ tread mill T elootrocordiograph 
(EKG) a«4 oth e r laboratory tooto. Psy- 
chologist or psychiatrist analyzes the psy- 
chological needs of the patients and 
counsels and or refers patients for treat- 
ment. The relaxation program is either 
led bv the psychologist or psychiatrist, or 
the psychologist or psychiatnst has pro- 
vided m- service training for other staff to 
carry it out. The psychologist or psychi- 
atnst also provides consultation to the 
staff members about suggested ways of 
dealing with emotional and psychological 
adjustments of the patients. 

(e) (-5^ Dietitian or nutntionist obtains diet 

histories, analyzes patient diets, and 
counsels patients and other pcrson(s) des- 
ignated by the patient on diet modifica- 
tion. 



^ 



in 



l£i 



Poycholopiot er povohiatriot onolyHoo (^ 
pcyohologioal neodo ef t+»® patients »fi4 
oounoolo and or refero pationto f»f treat 
mont. ¥^ relaxation program t« either 
k4 W y^ pGyohologist er poyohiatriot »f 
tb© pcyohologiDt ef poyohiatriot ha* ff^- 
vidod in oon'ioo training fof other staff to 
ooivf it »HtT ¥b« poyohologiot ef psyohi 
atriot ake pro video oonoultation to t^ 
staff momboro about ouggooted wayo ef 
dealing wt^ emotional as4 poyohologioal 
adjuotmento ef tfe© patiento. 
(^ Vocational rehabilitation counselor 
screens the program patients through a 
personal interview or vocation question- 
naire to determine those who have voca- 
tional potential or plan to return to work. 
In addition, the counselor develops ti*« 
vocational assessment, prescription, and 
intervention strategies, and provides 
counseling and other services as appropri- 
ate, r e quir e d to aohiosre t^ vocotionol 
objective fof patiento who become oLiente 
ef \^ North Carolina Divioion ef Vooa 
tional Rehabilitation. The counselor also 
attends staff meetings in which VR clients 
are to be discussed, counsels and provides 
follow-up to clients at the program, and 
participates in other program activities. 
Patient educator organizes the educational 
aspects of the program, including educa- 
tional matenals such as handouts, bro- 
chures, and newsletters. TTie patient 
educator is also responsible for the coor- 
dmation of the education lectures, mini- 



sessions, patient counsehng, and feedback 
sessions. 
(2) Additional Roles: 
(a) Exercise technologist works under the di- 
rection of the medical director and is re- 
sponsible for the administration of the 
graded exercise tests, mcluding the opera- 
tion of the treadmill, electrocardiograph 
(EKG), oscilloscope, and other laboratory 
tests. 



(b) 



Attending physician shall be on-site and 
available throughout the therapy includ- 
mg the specific warm-up. stimulus and 
cool-down phases, 
(c) Registered nurse serves as teacher, acts as 
haison person to other disciplmes, assists 
with medical emergencies, mamtains 
emergency equipment, helps to assess. 



3lan and evaluate mterdisciplinarv base 
plan of care, and maintains vital sign re- 
cords and symptomatology. 

Statutory Authority G.S. 131 E- 169. 



NORTH CAROLINA REGISTER 



39- 



PROPOSED RULES 



.0308 MINIMAL EDLCATIONAL STANDARDS 
OF STAFF POSITIONS AND 
ADDITIONAL ROLES 

(a) Staff Positions: 

( 1 ) <-»+ The program director of a certified 
cardiac rehabilitation program must meet 
the requirements of either Subparagraph 
(A) or (B) of this Paragraph: 

(A) Be an ACSM (Amencan College of 
Sports Medicine) certified program direc- 
tor or an ACSM certified exercise special- 
ist, and be certified in basic cardiac life 
support; or 

(B) Have a bachelor's, master's or doctorate 
degree in nursing, exercise physiology', or 
another health profession, 800 hours of 
cardiac rehabilitation expenence, and be 
certified in basic cardiac life support. 
Program directors not meeting these re- 
quirements who were employed by the 
program pnor to the September V^ 1989, 
effective date of these rules mav continue 
m their present position, and are encour- 
aged to seek contmuing education in ap- 
propnate subject matter. 

» nuroing. ex e rcis e phy&iolog>' ©f another 
health profoooion. Sift4 k»* boon c e rtified 
a* a program director ef oxeroioo cpooialiot 
by A(* .Vm e ncan CoUogo ef Sports .Modi 
oino: aH4 be oortifiod » baoio oardiao Itle 
support: »f 
^ hai ^ 'o ft baohulor'o dogroo » & health 6el4 
(e.g., ph; i sioal e ducation, nursing, oxoroiso 
physiology', health oduoation) ©f nursing 
degroo a»4 cardiac rehabilitation oxpon 
onoo: pres'ious e xperionoo m ti*e orgoniaa 
t*«« aft4 administration aft4 cup e P i ision 
©f personnel ; aH4 oortifiod m basio cardiac 
Me support. 

(b) The medical director of a certified cardiac 
rehabilitation program must meet the require- 
ments of either Subparagraph (1) or (2) of this 
Paragraph: 

(1) Have a medical degree, be licensed to 
practice medicine in North Carolina, be a 
board certified internist or cardiologist, 
aft4 have experience in the medical super- 
vision of cardiac rehabilitation programs, 
and b* certified » basic cardiac Irfe &«p- 
port; ef have recent expenence in emer- 
gency patient care: or 

(2) Have a medical degree, be licensed to 
practice medicme in North CaroUna, have 
expenence in electrocardiographic inter- 
pretation and in graded exercise testing. 



aA4 b« oortifiod » basic oardiao )^ sup 

(c) The exercise speaalist or coordinator of a 
certified cardiac rehabilitation program must 
meet the requirements of either Subparagraph (1) 
or (2) of this Paragraph: 

(1) Be certified as an exercise specialist or 
program director by the American College 
of Sports Medicine; and be certified m 
basic cardiac life support; or 

(2) Have a bachelor's degree e* oortifioation 
in a health field, have at least one year's 
previous experience in working with adult 
fitness and/or cardiac rehabilitation pro- 
grams, b» oortifiod m senior ]^ saving (4^ 
a swimming program i* offer e d): and be 
certified in basic cardiac life support, and 
supervised by the program director who 
has ACSM certification as an exernse 
specialist or program director. If the 
program does not have an ACSM certified 
exercise specialist or program director on 
staff, and significant weaknesses are iden- 
tified in this program component, the 
program may be required bv the Division 
to seek qualified consultation on an an- 
nual or semi-annual basis. 

(4^ ¥J*# exercis e technologist ef a certified eaf- 
diae rehabilitat i on program must moot the fs- 
quirements »f either Subparagraph f4-h f^ &f (^ 
ef ^ki« Paragraph: 

(4f b9 oortifiod a^ an oxoroiso toohnologist by 
tk» i\monoan CoUogo »i Sports Modicino. 
em^ with tbe ability te perform graded 
e xeroioo olootrocardiography; afi4 b* certi 
fi«4 i» basic life support; ef 
(4) be a rogistorod nurse e* have a bachelor s 

^^^^rt^^^a ^^^ ^L t^^^^^^^J^ ^^^^^^^- t^^^^^^ l^^^^^^^ ^^^^^^^^^^ 

OW^^^^^P ^n CT ^T^KB^^T TT^^^FT WC^^^? ^^^^W T^^T^^^^^ 

lodge aH4 oxporionoo m graded oxorciso 
t e sting aB4 e x e rcis e eloctrooardiography: 
a»4 be oortifiod m basic life support; m- 
(^ if R«» oortifiod ei% stated » f-H Q^ ^fe^ ^^^*^ 
agraph »f possessing ft degre e as stated m 
f34 ef ^b*& Paragraph, tl*e medical director 
must assure t4*a* tl*e person bas oompo 
tonoy ef trainmg and or oxpononco. have 
basic Icnowlodgo a«4 oxporionoo » graded 
e x e rcis e t e stmg aft4 e.xercise e l e ctrocardi 
ography: an4 be certified wi basic cardiac 
life support. 

(d) fe^ The dietitian or nutritiomst of a certified 
cardiac rehabilitation program must meet the re- 
quirements of either Subparagraph (1) or (2) of 
this Paragraph: 

(1) be a dietitian registered by the American 
Dietetic Association, bave a master s de- 
^«e » foods, nutrition, er othor health 



598 



yORTH CAROUNA REGISTER 



PROPOSED RULES 



profoooion, and be certified in basic car- 
diac life support; or 
(2) have a bachelor's or advanced degree in 
diototioo. foods, nutrition, or foods and 
nutrition, ef and a one year internship in 
a hospital practicing therapeutic dietary 
counseling, and be certified in basic car- 
diac life support. 
(e) f<^ The psychologist or psychiatrist of a 
certified cardiac rehabilitation program must 
meet the requirements of either Subparagraph ( 1 ) 
or (2) of this Paragraph: 

(1) be a licensed practicing psychologist in 
North Carolina (doctoral level) or a li- 
censed psychological associate monitored 
and supervised by a licensed practicing 
psychologist, have a minimum of two 
years of acceptable and appropriate pf©- 
foooionol exp>erience, and be certified in 
basic cardiac life support; or 

(2) be a board certified psychiatrist licensed to 
practice medicine in North Carolina, have 
a minimum of two years of acceptable and 
appropriate professional experience, and 
be certified in basic cardiac life supf)ort. 

[f} (g> The vocational rehabilitation counselor 
of a certified cardiac rehabihtation program must 
be a rehabilitation counselor with a master's de- 
gree in rehabilitation counseling or a related field, 
or have a bachelor's degree and be appropriately 
qualified to provide vocational rehabilitation ser- 
vices. The vocational rehabilitation counselor 
must be certified m basic cardiac life support. 

(g) The patient educator of a certified cardiac 
rehabilitation program must either have an R.N. 
degree or a bachelor's degree in a health field 
(nursing, health and sport science, physical ther- 
apy ) , have had basic coursework, training, and 
experience in patient education with an adult 
population, and be certified in basic cardiac life 
support. 

(h) Additional Roles: 
( 1) The exercise test technologist of a certified 
cardiac rehabilitation program must meet 
the requirements of either Subparagraph 
(A), (B), or (C) of this Paragraph: 

(A) Be certified as an exercise test technol- 
ogist bv the Amencan College of Sports 
.Medicme, and be certified in basic cardiac 
life support; or 

(B) Be a registered nurse or have a bach- 
elor s degree in a health field, have a basic 
knowledge and experience in graded exer- 
cise testing and exercise electrocardiogra- 
phy, and be certified in basic cardiac life 
support; or 

(C) If not certified as stated in Subpara- 
graph (A) of this Paragraph or possessing 



a degree as stated in Subparagraph (B) of 
this Paragraph, the medical director must 
assure that the person has competency of 
training and; or experience, have basic 
knowledge and experience in graded exer- 
cise testmg and exercise electrocardiogra- 
phy, and be certified m basic cardiac life 
support. 

(2) The attending physician of a certified car- 
diac rehabilitation program must have a 
medical degree, be licensed to practice in 
North Carolina, have competency to di- 
rect other staff in a medical emergencv, 
and must be approved, in writing, by the 
medical director. 

(3) The registered nurse of a certified cardiac 
rehabilitation program must be licensed 
to practice professional nursing in North 
Carolina, have competency to assist other 
staff in a medical emergency, be compe- 
tent in basic EKG interpretations, have 
at least one year experience in cardiac re- 
habilitation or equivalent (i.e., 
coronary/critical care nurse), and be certi- 
fied m basic cardiac life support. 

Statutory Authority G.S. I3IE-I69. 

SECTION .0400 - PROGRAM ADMISSION 
CRITERIA: PATIENT ASSESSMENT 

.0407 ADMISSION CRITERIA 

Patients entering a certified cardiac rehabili- 
tation program must have one or a combination 
of the following: 

(1) Myocardial infarction: 

(a) j\ny A p>ost-myocardial infarction patient 
may enter a program any time at the dis- 
cretion of the medical director and referral 
from a personal physician. 

(b) There must be adequate control of com- 
plications, i.e., angina, congestive heart 
failure, arrhythmias, etc., according to the 
medical director and the referrmg physi- 
cian. 

(2) Angina pectoris: recent changes in medica- 
tion for angina control are permissable at the 
discretion of the patient's personal physi- 
cian. 

(3) Post-operative cardiovascular surgery or 
interventional procedures, i.e., CABG, 
PTCA, valvular, congenital or peripheral 
surgery: 

(a) A minimum ef throo woolto following aef- 
to oofonar^' bypaoo ourgor^' \s> roquirod 
before admiooion te tfe« program ef A 
post-operative cardiovascular surgery pa- 
tient may enter a program or at any time 



NORTH CAROLINA REGISTER 



399 



PROPOSED RULES 



at the discretion of the medical director 
and referral from a personal phv^ician. 
(b) A post -operative valvular, congemtal or 
p>enpheral obstructive surgery patient ea» 
mav be admitted with the admission date 
bemg at the discretion of the refemng 
physician and medical director. 

(4) Hypertension: patients with low functional 
capaaty or a specified need to maintam 
therapy may be admitted to the program. 

(5) .Arrhuhmias: 

(a) Patients with serious arrhylhmias and or 
conduction defects . may ais» be admitted 
to the program. 

(bi Pacemaker patients with any of the diag- 
noses contained in this Rule and or de- 
creasmg functional capaaty eaft mav be 
admitted to the program. 

(6) Other conditions which af© mav be con- 
sidered grounds for admission include, but 
are not limited to: cardiomyopathies, valvu- 
lar heart disease, ©ter cardiac transplant, 
COPD. diabetes, and disabling renal disease. 
Appropnate assessment, prescriptive and 
therapeutic modifications must be docu- 
mented. 

Siatuiory Authority G.S. 13IE-I69. 

.0408 PATIENT .ASSESSMENT 

Upon admission to the cardiac rehabilitation 
program each patient must have a medical record 
de\eloped which mcludes wntten documentation 
of the disabling condition and an assessment. 
This assessment must mclude: 

(1) Medical Assessment: 

(a) Cardiovascular evaluation as to present 
diagnosis, therapy and condition and a 
discharge summary of the patient's last 
hospitalization: or 

(b) Statement by referring physicians as to 
present diagnosis, therapy and condition. 

(2) Laboratory Assessment: 

(a) Resting 12-lead electrocardiogram: 

(b) Graded exerase test with 12-lead electro- 
cardiogram: 

(c) Blood chemistry afi4 oomploto blood 
count (CBC). to mclude total cholesterol, 
high density lipid litxiprotein (HDL), aft4 
tnglycerides, and glucose: 

(d) Functional work capacity as determined 
bv measured or predicted equivalents 
(METS): 

(e) Pulmonary function studies, if available: 
mdicated: and 

(f) Height, weight, percent body fat, and ideal 
weight. 

(3) Dietan- Assessment: 



(a) Nutrition history containing socio-eco- 
nomic, medical, anthropometric, dietary 
and atlitudinal information; 

(b) Written three-to- seven day diet record; 

(c) Review of medical history and assessment, 
recent serum lipid analysis, and anthro- 
pometric analysis; 

(d) Nutntion interview with patient and ap- 
propnato family mombor; other person(s) 
designated by the patient; and 

(e) Behavior survey considermg frequency, 
motivation, location and impediments to 

, eating. 

(4) Psychological Assessment: 

(a) Psychological interview and questionnaire; 
and 

(b) Screening for psychopathology and beha- 
vorial dimensions such as a state-trait 
anxiety, depression, and Type A behav- 
ioral pattern. 

(5) Vocational Assessment: 

(a) Vocational questiormaire to determine 
current vocational status, descnption of 
physical requirements of job, working 
conditions and psychological demands as 
perceived by the patient; and 

(b) Vocational questionnaire and or mter\iew 
to detemune demographic and fmancial 
data, establish proper counselor client re- 
lationship, complete agency documenta- 
tion to assess eligibility for agency 
services, and to assess need for further di- 
agnostic procedures for those individuals 
who apply for vocational rehabilitation 
services. 

Statutory Authority G.S. 1 31 E- 169. 

SECTION .0500 - INDIV IDL AL CARDIAC 
PATIENT REHABILITATION PLAN 

.0506 TEAM COORDINATION AND 
STAFFINGS 

(a) A multi-disciplinary team approach is used 
to implement each patient's cardiac rehabilitation 
program. This team bnngs together all of the 
disciplmes involved to remediate cardiac nsk fac- 
tors and carry out therapy. 

(b) On the basis of their assessments, the car- 
diac rehabilitation staff shall decide upon the 
most appropnate means of inter\'ention for each 
patient. Within four weeks of entry mto the 
program, a prescription shall be developed by 
each staff member. 

(c) The team staffmg report, at a minimum, 
shall include a coordmated therapeutic plan of 
exercise therapy, diet therapy, psychological ser- 
vices, and vocational rehabilitation counseling 



400 



SORTH CAROLINA REGISTER 



PROPOSED RULES 



and services. This report oholl must tfe«» be sent 
to the patient's personal andor referring physi- 
aan. with a copy maintained in the medical re- 
cord. 

(d) .\11 multi-disaplinary staff (exercise coordi- 
nator, psychologist, and nutritionist), will attend 
a minimum of one cardiac therapy session per 
week and one patient staifmg per month. The 
vocational rehabilitation counselor assigned to 
the program shall attend at least those staifmgs 
at which VR clients are discussed. 

Statutory Authority G.S. I3IE-169. 

.0507 CARDIAC THERAPY 

(a) Unless medically contraindicated, each in- 
dividual's rehabilitation plan shall include: 

(1) Tyf)e of cardiac therapy: gymnasium 
(walk/jog) program, swimming 
(walk/swim), bicycle ergometrv. arm er- 
gometry, circuit training, or treadmill 
walking program; otationar>f bioyole; 

(2) Intensity: 60 to 85 percent of safe funo 
tional capacity; svmptom-limited heart 
rate reserve; 

(3) Duration: at least 45 minutes duration 
with a minimum of 30 minutes at the 
stimulus phase and remaiiung time in 
warm-up cool-down; and 

(4) Frequency: minimum of three non-conse- 
cutive da> s per week. 

(b) At the discretion of the medical director, 
the patient may be monitored continuously or 
mtermittently through the use of electrocardiog- 
raphy while periorming the cardiac therapy de- 
scribed in Paragraph (a) of this Rule. 

(c) TTiere shall be an attending physician on- 
site and available before a cardiac therapy session 
begms with the specific warm-up, stimulus and 
cool-down phases. In the event that a physician 
is not available, the session shall be sust>ended 
or an educational program may be substituted for 
cardiac therapy. 

(d) A staff to patient ratio in the cardiac ther- 
apy sessions should be at least 1:12 for all pro- 
grams. 

Statutory Authority G.S. I3IE-I69. 

.0508 DIET THERAPY 

Each mdividual s program shall include the fol- 
lov\mg dictar>' ser\ices: 

( 1 ) Interpretation and feedback of nutrition 
assessment to patient spouse; 

(2) Patient spouse counseling on nutrition for 
good health, food selection and preparation, 
with prescription of a therapeutic diet if ne- 
cessary; 



(3) Eating behavior modification whoro when 
appropriate; and 

(4) Identification of a weight goal and weight 
reduction classes if necessary. 

Statutory Authority G.S. I3IE-I69. 

.0509 PSYCHOLOGICAL SERVICES 

Each individual's program shall include the fol- 
lowing psychological services: 

(1) Interpretation and feedback of psycholog- 
ical assessment to the patient. 

(2) Recommendations concerning aH4 an ap- 
propriate plan of counseling/therapy (on-site 
or referral) which may include one or more 
of the following: indi' i 'iduol aH4 group 
thorapy, ^ noodod: Dtrooo managomont, Fe- 
laxation training, omoldng oeosation, aH4 
bohavior modification. 

(a) individual or group therapy; 

(b) stress management; 

(c) relaxation trairung; 

(d) smoking cessation; and 

(e) behavior modification. 

(3) The psychologist shall personally conduct 
sessions, or instruct other staff to conduct 
sessions, so that relaxation or stress man- 
agement is offered at least once a week. 

Statutory Authority G.S. I3IE-I69. 

SECTION .0600 - PROGRESS EVALUATION 
AND FOLLOW-LP 

.0614 PROGRESS EVALUATION AND 
FOLLOW-UP PROCEDURES 

Patient foUow-up shall include: 

( 1) fa^ Following the implementation of each 
cardiac patient's rehabilitation plan, routine 
monitoring of patient progress shall be ac- 
complished. Changes to each patient's plan 
shall be made as appropriate, based upon 
evaluations. In some instances, p)ost-disc- 
harge follow-up and evaluation may be de- 
sirable. 

(2) f^ Progress evaluation and other informa- 
tion pertaining to each patient's partic- 
ipation in the program shall be 
communicated with the staff, through f#§- 
uiar formal afi4 informal verbal a»4 written 
oommunioation. 

(3) Reports of progress shall ht sent to the 
refemngpersonal physician at regular fol- 
low-up intervals, defmed as three, six, and 
12 months after entry. If the patient con- 
tmues in the program after J_2 months, the 
results of annual re-evaluations should also 
be reported to the referring physician. 



NORTH CAROLINA REGISTER 



401 



PROPOSED RULES 



Statutory Authority G.S. 1 31 E- 169. 

.0615 MEDICAL FOLLOW-LP 

Medical follow-up procedures shall include: 



(1 



evaluation of patient progress in functional 
capacity through examination of graded ex- 
ercise testing (GXT) data at retooting (4t 4 
aft4 44 montho i : regular follow-up internals. 
II i GXT IS not done, the record must con- 
tam documentation of the reason U was de- 
ferred: 

(2) consultation with professional staff regard- 
mg progress made by patients towards spec- 
ified goals (e.g., functional capacity, smokmg 
cessation, dietary modification, weight and 
lipid control, psychological status, voca- 
tional status): 

(3) consultation v.ith staff regarding patient 
medications: and 

(4) consultation regarding alternate medical 
surgical intervention (e.g., catheterization, 
surgery). 

Statutory Authority G.S. 131 E-169. 

.0616 C.ARD1.\C THERAPY FOLLOW-LP 

Cardiac therapy follow-up procedures shall in- 
clude: 

( 1 ) momtormg of patient adherence to exercise 
prescnption by systematic exammation of 
patient records (intensity and frequency of 
cardiac therapy sessions) at monthly inter- 
vals, and documentation of feedback to the 
patient 

(2) periodic review of the exercise prescnption 
for appropriate intensity and duration: and 

(3) consultation with medical director on exer- 
ase prescnption changes when needed (i.e., 
at follow-up GXT's and or change m medi- 
cation). 

Siatutor,- .Authority G.S. I3/E-/69. 

.0617 DIETARY FOLLOW-LP 

Dietary foUow-up procedures shall mclude: 
( 1 ) Patient records of weight at least weekly 
and as a component of stress test protocol 
at ir 4t aft4 4-3 montho mi^ ii^ program: 
regular foUow-up intervals: 

Re\iew of medicaj status results, as well as 

lipid aft4 onthropomotnc roculto a* ir ^ mi4 

44 montho: body composition and dietar^' 

status results at regular follou-up inler.als: 

(4+ QL . OL'cumont <^ diotorr otatuo. uoma 21 hour 



(2) 



(4^ Bew food rooordo may b^ imtiatod whon t»» 
progroDO »*• mado to' i vord onthropomotno Bf 

(3) (-^ Referral and follow-up to indi\idual or 
group diet program to facilitate achievement 
of dietary goals, especially weight reduction: 

(4) (4) Periodic momtormg of the incorpo- 
ration and mamtenance of appropnate die- 
tary modifications. 

Statutory Authority G.S. 13/ E-169. 

.0618 PSYCHOLOGICAL FOLLOW-LP 

Psychological follow-up must include evalu- 
ations made aft©? 4-3 as4 +8 montho ef admiooion 
at regular foUow-up mtervals to determine the 
extent to which the patient has been able to 
maintain needed changes m lifestyle and copmg 
skills. This may be accomphshed by inters'iew 
or psychometnc assessment. 

Statutory Authority G.S. 131 E-169. 

.0619 VOCATIONAL REHABILITATION 
FOLLOW-LP 

Vocational rehabilitation follow-up on spon- 
sored clients shall include: 

discuss 



progress 



recall, food rooord, ef food froquoncy quoo 
tionnairo: 



(1) Counseling sessions to 
made in the rehabilitation plan: 

(2) Contact with clients (and employer, if 
needed) after return to work or exit from the 
program; and 

(3) Other appropriate vocational rehabilitation 
services. 

Statutory Authority G.S. 131 E-169. 

SECTION .0700 - PROGRAM DISCHARGE 

.0706 CRITERIA FOR DISCHARGE 

Six to twelve months is usually necessary for the 
significant rehabilitation of most cardiac patients. 
Upon deliberation and at the discretion of the 
rehabilitation program staff, a patient may be 
discharged after satisfactory improvement or a 
minimum of six months participation if appro- 
priate levels are met for functional capacity, 
medical status, physical fitness and education. 4 
t^ following cntona a** »*«t 
f4-^ functional capacity: minimum »f oight m^- 
tabolio oquivolontc . (NtETS) ©f abdiiy v» 
' ■ ' ■ ork at A* upper proocnbod hmit ' . vithout 
angma. oigmfioont arrhylhmiao e* abnormQ 4 
homodynamio rooponoo: 
(34 modicol statue: 
faf oloctrocordiogram a4' ma)umum oxorciDo: 
(++ normal e* unohongod conduction: 
(tt) \»%% {44a» throo mff^ ^rf- doproooion at 
HRmax; a»4 



402 



SORTH C A ROLLS' A REGISTER 



PROPOSED RULES 



(4i^ ajTh; i ^hiniQD otablo eF aboont; 
f^ angina, otablo »f aboont: 
fe) blood pr e sBuro rt Fee* bolow 160/90 

nimHG: 
(4f rooting heart Fate bolow 9© boato/minuto; 

f^ phyoioal fitneoo: adoquato phvoioal fitneoo 
noooooar/ i%f daily aotivities a»4 oooupation 

f4^ oduoation: pationto ohould oatiofaotorily 
undorotond: 
<t^^ Ae baoio pathophyoiolog'y »f tbe oardio 

vaooulof diocaso proo e es; 
(^ roaoono fef th« intor i 'ontion mothodo uood 
» oordiao rohabilitation. Ft^tt phyoioal ae- 
tivity aH4 poroonal hoort rate a»4 oyotom 
monitoring. 4t«^ a»4 poyohologioal a6- 
oooomont aH4 thorapy; a»4 

hav e boon proocribod fof them. 

Statutory Authority G.S. 1 31 E- 169. 

.0707 DISCH.\RGE PLAN 

A final decision is made by the cardiac rehabili- 
tation staff to discharge the patient from the 
program into another appropriate program 
(home. YMCA, Cardiac Fitness Graduate, or Statutory Authority G.S. I3IE-I69. 
other), e* retain fef aft additional st* montho. 
This discharge should be documented and com- 



Statutory Authority G.S. I3IE-I69. 
.0807 RECORD REVIEW CONSENT 

^^r^ I ' IT-^nv^ff ^W^^^^^B ^^^^^TT ^^^H^^ff Sn^^D ^^v LW-f IV 

oatod a6 te' aoouro tka( mediool rooords shall be 
protect od from unauthoriaod dioclooure. A^ 
modioal rooordo ohoU be otorod ift » safe aft4 «e- 
ew« onvironmont. 

(^ ¥he oortifiod oordiac rohabilitation program 
muot havo polioioo to' aoouro t^tat- medical rooordo 
afe retained tft aooordonoo with \km North Coro 
bna otatutoo ef limitationo, Q^ 4-44 afi4 1 17. 

(e^ Provioiono skaU b« mado i^f a patient er 
kte legal reprooontativo to havo aooooo to ^rt» in- 
formatioR contained ift lu6 mediool record unless 
ouch aoooso t6 m e dioolly oontroindioated. 

f4^ The record of each patient must contain a 
statement signed by the patient which reads as 
follows: "I understand that in accordance with 
N.C. General Statute 131E-170, I have the right 
to object in writing to a review of my record or 
record information by the Dopartmont ef Human 
RoDourooo Division of Facility Services represen- 
tatives during state certification inspections and 
by an objection in writing I may prohibit the in- 
spection or release of my records." 



mumcated to the referring personal physician. 
Statutory Authority G.S. 1 31 E- 169. 

SECTION .0800 - MEDICAL RECORDS 

.0806 POLICIES AND PROCEDURES 

Each certified cardiac rehabilitation program 
shall have policies and procedures which shall be 
implemented to provide for at least the following: 

(1) maintenance of a complete, ftft4 accurate 
and organized medical record for each pa- 
tient admitted to the program; 

f^ filing ef medical rooordo to onouro acoooDi 
bility fof oompilin 'g aft4 retrieving informa 

(4^ ouponioion »f medical records; 

(2) f4^ confidentiality of records; 

(3) (4^ accessibility or non-accessibility of med- 
ical record information to the patient, pro- 
gram staff and non-employees; 

(4^ retention »f rooordo: 

f^ disposition ef r e cords; aft4 

f^ charting aft4 indexmg &f records. 

(4) retention and disposition of records in ac- 
cordance with the N C. Statutes of Limita- 
tions, G.S. 1-15, 1-17. 



.0808 CONTENT OF MEDICAL RECORD 

(a) All entries in the record shall be legible and 
signed by the individual making the entry with a 
signature, title, and date. 

(b) The patient's name must be recorded on 
each page of the record. 

(c) The medical record shall contain at least the 
following: 

(1) patient identification data; 

(2) medical history and/or hospital discharge 
summary; 

(3) graded exercise data; 

(4) record of oxygen uptake where appropri- 
ate; 

(5) records of blood chemistry analysis in- 
cluding lipid profile; 

(6) informed consent to participate in the 
programs; 

(7) reports of physical examinations; 

(8) progress notes and response to the thera- 
peutic plan; 

(9) vocational questionnaire; 

(10) all records of each discipline's partic- 
ipation in the program; patient's thera- 
peutic plan; 

(11) discharge plans providing for post-disc- 
harge program continuity and foUow-up 
as appropriate; and 



NORTH CAROLINA REGISTER 



403 



PROPOSED RULES 



(12) rmsceUaneous records desirable for pro- 
gram continuity. 

Statutory Authority G.S. 1 31 E- 169. 

SECTION .0900 - EMERGENCIES 

.0901 EMERGENCY PL.\N 

A wntten plan must be established which is 
sufficiently fle.xible to handle all possible emer- 
genaes. must W ootabliahod. .AJl areas of the 
premises (i.e., testing lab, pool, parking lot, 
locker room. room(s)l. et^ must be included. 
The plan shall address the assignment of person- 
nel and availability o{ equipment which is subject 
to use in an emergency. ohoU b© addroccod » ti*« 
plan .All patients shall be informed during ori- 
entation that staff super^'ision ceases when the 
patient exits the program "site". 

Statutory Authority G.S. 1 31 E- 169. 

.0902 EMERGENCY EQLIPMENT 

equipment aft4 dfwe in' i ontorr t* roquirod A 
vmti ^ n record e^" monthly omorgoncy drills » f©- 
quirod. Hie foUowmg equipment and supplies 
must be available and operable m an emergency: 

(1 



ill 

lii 
ill 

(6l 



suction equipment (portable): 

defibrillator (portable): 

mtubation equipment: 

drug kit: 

oxygen tank supplv: 

regulator and mask or nasal cannula. 



Statutory Authority G.S. I3IE-169. 

.0903 PERSONNEL 

For out-of-hospital cardiac rehabilitation pro- 
grams: 

( 1 ) Two medical personnel must be present 
dunng the warm-up, stimulus, and cool- 
down phases of the cardiac therapy session. 
The medical personnel must consist of the 
attending physician and at least one of the 
foUowmg qualified personnel: registered 
nurse, physician, physiaan s assistant. The 
options are: 

(a) two .M.D.'s, or 

(b) one M.D. and one Physician s .Assistant 
licensed to work under that doctor, or 

(c) one M.D. and one registered nurse, or 

(2) For in-hospital programs: 

(a) The physician must be in-house but not 
involved m such activities as surger.. car- 
diac cath. etc. In other words, he she 
must be immediatelv available bv some 



direct emergency contact system. This 
system must be tested at regular ur als. 

(b) Backup code-blue team response : be 
available. 

(c) One certified Advanced Cardiac L; up- 
port (.ACLS) staff member able to i.r.ple- 
ment approved ACLS protocol should be 
present at the exerase site. 

Statutory Authority G.S. 13IE-169. 

.0904 EMERGENCY DRILLS 

.A wntten record of monthly drills should be 
documented. In the record, a daily review of the 
crash cart equipment and a monthly drug inven- 
tory is required. The drills should be directed, 
and the effectiveness of the drill should be re- 
viewed, dociimented, and signed by, the medical 
director or attending physician. 

Statutory Authority G.S. 1 31 E- 169. 

SECTION .1000 - F.ACILITIES AND 
EQLIPMENT 

.1001 PROGRAM REQUIREMENTS 

(a) Facilities and equipment necessary for the 
delivery of each phase of the cardiac rehabili- 
tation program must be readily a\-ailable for use. 

(b) A wntten preventive mamtenance program 
shall be established to ensure that all equipment 
IS mamtamed in safe and proper working order. 

(c) A quality assurance program providing 
must be pro\ided for penodic calibration of test 
equipment which h in accordance with man- 
ufacturers recommendations or other generally 
accepted standards. 

Statutory Authority G.S. 13IE-I69. 

.1002 GRADED EXERCISE TESTING 
LABOR.\TORY E\ ALLATION 

The followmg facilities and equipment shall be 
available for graded oxoroioo testing: laboratory 
evaluation: 

( 1 ) adequate space for physical examination 
and graded exercise testing; 

(2) 12-lead electrocardiographic equipment for 
exercise testing; 

(3) oscilloscope for electrocardiographic (FCG) 
monitonng or continuous recordmg; 

(4) treadmill, and or bicycle ergometer and or 
arm crank ergometer; 

(5) dotlbnUator, oxyg e n tonic, regulator aA4 
maok aft4 omorgoncy drugo; sphygmoma- 
nometer, blood pressure cuff, and stetho- 
scope: 

(6) blood proooure e«ff es^ Dtothoocopo; emer- 
gency procedures, equipment, and supplies 



404 



SORTH CAROLINA REGISTER 



PROPOSED RULES 



as described in Section .0900 of this Sub- Statutory Authority G.S. 131 E- 169. 



chapter on emergencies; 

(7) anthropometric equipment (skinfold cali- 
pers, stadiometer and phyoioian physician s 
balance scale); and 

(8) spirometer for pulmonary function testing. 

Statutory Authority G.S. I3IE-I69. 

.1003 CARDIAC THERAPY 

The following facilities and equipment shall be 
available and operable for the cardiac therapy 
program: 

(1) gymnasium, multipurpose room, or track; 

(2) tolomotr>' t^Mtt ollowo ^ oontinuouo »t««- 
trooordiographio monitoring >v'hon dotor 
minod noooooof)' by \k» m e dioal direotor; 
portable ECG and oscilloscope; 

(3) portable olootrooardiograph; sphygmoma- 
nometer, blood pressure cuff, and stetho- 
scope; 

(4) Doporato portable elootrooardiographio mon 
kef wit^ defibrillator, blood prooouro eu#7 
otothosoopo; emergency procedures, equip- 
ment, and supplies as described in Section 
.0900 of this Subchapter; 

( 5) oooilloocopo; large clock with a sweep second 
hand; 

(6) recreational games equipment if deemed 
necessary^ and appropriate by the program 
direction or e.xercise specialist. 

f^ omorgonoy oquipmont: 
f»^ suction equipment, 
(M dofibnliator, 
fe^ intubation oquipmont, 

(^ oxygon tank, 
(4^ regulator an4 maok, 
f§^ otrotoher, a«4 
fk) towelo fef pool program. 
Irh rooroational gamoo oquipmont; a«4 

\^ I ^I^T^^ff tTTT^T W CT^t^^^^T 3^^^^^^^ct nC^R^^T 

Statutory Authority G.S. 1 31 E- 169. 

.1004 DIETARY PROGRAM 

The followmg facilities and equipment shall be 
available for the dietar>' program: 

(1) Adequate space for interviewing and coun- 
seling; 

(2) Dietary tables and means of nutrient anal- 
ysis; 

(3) Availability of equipment or service for 
blood serum lipid analysis; and 

(4) Appropnale educational materials for pa- 
tient distribution and use during the dietary 
consultation. 



.1006 VOCATIONAL REHABILITATION 
PROGRAM 

Adequate space must be available for the voca- 
tional rehabilitation program to allow for confi- 
dential interviewing and counseling. 

Statutory Authority G.S. I3IE-I69. 

■k***-k***-k-k*****1s** 



No 



otice is hereby given in accordance with G.S. 
1 508- 1 2 that the Division of Health Services in- 
tends to amend rule(s) cited as 10 NCAC 7 A 
.0209; IB .0337. .0347, .0349 ■ .0351; 8D .0204. 
.0701; lOD .1624. .1638. .1640. .2409; WF .0032, 
.0034; JOH .0203; adopt rule(s) cited as JO 
NCAC WD .1642; repeal rule(s) cited as 10 
NCAC I CD .1633. 

1 he proposed effective date of this action is No- 
vember I. 1989. 

1 he public hearing will be conducted at 1:30 
p.m. on August 3. 1989 at Caswell Building, 
Board Room (First Floor i Room No. 179). 200 
W. Jones Street, Raleigh, North Carolina. 

y^ommenl Procedures: Any person may request 
information or copies of the proposed rules by 
writing or calling John P Barkley. Agency Legal 
Specialist, Division of Health Services, P.O. Box 
2091, Raleigh. North Carolina 27602-2091, (919 j 
733-3134. Written comments on these rule 
changes may be sent to Mr. Barkley at the above 
address. Written and oral comments (no more 
than ten minutes for oral comments) on these rule 
changes may be presented at the public hearing. 
Notice should be given to Mr. Barkley at least 
three days prior to the public hearing if you desire 
to speak. 

CHAPTER 7 - HEALTH: EPIDEMIOLOGY 

SUBCHAPTER 7A - ACLTE COMMUNICABLE 
DISEASE CONTROL 

SECTION .0200 - CONTROL MEASURES FOR 
COMMUNICABLE DISEASES 

.0209 CONTROL MEASURES 

(b) In interpreting and implementing the spe- 
cific control measures adopted in Paragraph (a) 
of this Rule, and in devising control measures for 
outbreaks designated by the State Health Direc- 
tor and for communicable diseases and condi- 
tions for which a sp)ecific control measure is not 



NORTH CAROLINA REGISTER 



405 



PROPOSED RULES 



provided by this Rule, the following principles 

shall be used: 

( 1 ) control measures shall be those which can 
reasonably be expected to decrease the 
nsk of transmission and which are con- 
sistent with recent scientific and public 
health information; 
(d) The foUowmg are the control measures for 

the Acquired Immune Deficiency Syndrome 

(AIDS) and Human Immunodeficiency Virus 

(HIV) infection: 

(4) When health care workers or other per- 
sons have had a nonsexual blood or body 
fluid exposure that poses a significant risk 
of transmission, the following shall apply: 

(A) When the source person is known: 
(i) The attending physician or occupa- 
tional health care provider responsible 
for the exposed person shall notify- the 
attending physician of the person whose 
blood or body fluids is the source of the 
exposure that an exposure has occurred. 
If the attending physician of the source 
person knows the source's HIV in- 
fection status, the physician shall trans- 
mit this information to the attendmg 
physician of the exposed person. If the 
attending physiaan of the source per- 
son does not know the infection status 
of the source person, the physician shall 
discuss the exposure with the source 
and if the source person is at high risk 
for HIV infection, shall request f>ermis- 
sion for testmg for HIV infection. If 
permission is granted, the source shall 
be tested. If permission is denied, the 
local or state health director may order 
testmg of the source if the local or state 
health director determines that the ex- 
posure poses a significant nsk of trans- 
mission of HIV and that the source is 
at high risk for HIV infection. How- 
ever, if permission is demed and the 
source is in the custody of the [>epart- 
ment of Correction, the Medical Direc- 
tor of the Di\ision of Pnsons mav order 
testmg of the source if the Medical Di- 
rector determines that the exposure 
poses a significant nsk of transmission 
of HIV and that the source is at high 
nsk for HI\" infection. WTicther or not 
the source is tested, the attendmg phy- 
sician of the exposed person shall be 
notified of the nsk status of the source 
and the infection status of the source, 
if known. 

(5) The attendmg physician shall notify the 
local health director when the physician, 



in good faith, has reasonable cause to 
susf)ect a patient infected with HIV is not 
following or caimot follow control meas- 
ures and is thereby causing a significant 
risk of transmission. Any other person 
may notify the local health director when 
the person, in good faith, has reasonable 
cause to suspect a person infected with 
HIV is not followmg control measures 
and IS thereby causmg a significant nsk of 
transmission. 
(7) The Director of Health Services of the 
North Carolina Department of Correction 
and the prison facility admimstrator shall 
be notified h^ tfe© attending physician ef 
aaȴ HIV infootod when anv person con- 
fmed in a state prison is deterrruned to be 
infected with HIV. If the prison facility 
administrator, m consultation with the 
Director of Health Services, determines 
that a confmed HIV-infected person is not 
following or cannot follow prescnbed 
control measures, thereby presentmg a 
significant risk of HIV transmission, the 
administrator and the director shall de- 
velop and implement jointly a plan to 
prevent transmission, including making 
appropriate recommendations to the umt 
housmg classification committee. 
(13) A person charged with an offense that 
involves nonconsensual vagmal, anal, or 
oral intercourse, or that involves vaginal, 
anal, or oral mtercourse with a child 12 
years old or less shall be tested for HIV 
infection if: 

(A) probable cause has been found or an 
indictment has been issued; 

(B) the victim notifies the local or state 
health director and requests information 
concenung the HIV status of the defend- 
ant; and 

(C) the local or state health director deter- 
mines that the alleged sexual contact in- 
volved in the otfense would pose a 
significant risk of transmission of HIV if 
the defendant were HI\' infected. 

If in custody, the person shall be tested by 
the Department of Corrections and if not in 
custody, the person shall be tested by the 
local health department. The Department 
of Conections shall inform the local health 
director of all such test results. The local 
health director shall inform the victim of the 
results of the test, counsel the victim appro- 
priately, and instruct the victim regarding the 
necessity for protecting confidentiality. 

Statutory Authority G.S. I30A-144. 



406 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



SLBCHAPTER 7B - HIGHWAY SAFETY 

SECTION .0300 - BREATH ALCOHOL TEST 
REGLLATIONS 

.0337 PREVENTIVE MAINTENANCE: 
BREATHALYZER: MODELS 900 
and 900A 

TTie preventive maintenance procedures for 
Breathalyzer Models 900 and 900A to be fol- 
lowed at least once during every 30 days are: 

(1) Verify appropriate sample chamber output; 

(2) Verify appropriate delivery time; 

(3) Verify appropriate timer cycle (Model 900A 
only); 

(4) Verify that optical system is functioning 
properly; 

(5) Verify instrument thermometer shows 50 
degrees plus or minus 3 degrees C; 

(6) Verify alcoholic breath simulator ther- 
mometer shows proper operating temper- 
ature; 

(7) Verify instrumental calibration by con- 
ducting two consecutive alcoholic breath si- 
mulator tests and record results; 

(8) Verify alcohobc breath simulator solution 
IS being changed ever>' 44 J_5 days or after 
25 tests; whiche\er occurs first. 

A signed copy of the preventive maintenance 
checklist shall be kept on fde for at least three 
years. 

Statutory Author ity G.S. 20-139.1 (b). 

.0347 PREVENTIVE MAINTENANCE: 
BREATHALYZER: MODEL 2000 

The preventive maintenance procedures for the 
Breathalyzer, Model 2000 to be followed at least 
once during every 30 days are: 

(1) When instrument displays "INSERT 
TICKET", insert test record; 

(2) Verify alcoholic breath simulator ther- 
mometer shows proper operating temper- 
ature; 

(3) WTien "READY" appears, press 
■START TEST '; 

(4) When 'BLOW SA.MPLE" appears, collect 
breath sample; 

(5) When "BLOW SAMPLE" appears, con- 
nect alcoholic breath simulator and push 
"ST.^RT.TEST", disconnect when "ANA- 
LYZE" appears; 

(6) When "BLOW SAMPLE" appears, con- 
meet alcoholic breath simulator and push 

"START/TEST", disconnect when "ANA- 
L'^'ZE" appears; 



(7) When "ANALYSIS COMPLETE" ap- 
pears, remove test record and record simu- 
lator results; 

(8) Verify alcoholic breath simulator solution 
is being changed every 44 15 days or after 
25 tests, whichever occurs first. 

A signed copy of the preventive maintenance 
checklist shall be kept on file for at least three 
years. 

Statutory Authority G.S. 20-139.1 (b). 

.0349 PREVENTIVE MAINTENANCE: 
INTOXIMETER: MODEL 3000 

The preventive maintenance procedures for the 
Intoximeter, Model 3000 to be followed at least 
once during every 30 days are: 

(1) Verify alcoholic breath simulator ther- 
. mometer shows projjer operating temper- 
ature and insure simulator is properly 
coimected to instrument; 

(2) Verify instrument displays proper time and 
date; 

(3) Press "START" key and enter appropriate 
information; 

(4) Verify instrument displays expected results 
from the alcoholic breath simulator; 

(5) When "SUBJECT BLOW" appears, collect 
breath sample; 

(6) When "SUBJECT BLOW" appears, collect 
breath sample; 

(7) When test record ejects, remove and record 
simulator resuhs: 

(8) Repeat steps (1) through (7); 

(9) Verify alcoholic breath simulator solution 
is being changed every 44 j_5 days or after 
25 t«s*7 tests, whichever occurs first. 

A signed copy of the preventive maintenance 
checklist shall be kept on file for at least three 
years. 

Statutory Authority G.S. 20-139.1 (b). 

.0350 INTOXILYZER: MODEL 5000 

The operational procedures to be followed in 
usmg the Intoxilyzer, Model 5000 are: 

(1) Insure observation penod requirements 
have been met; 

(2) f^ Insure instrument displays proper time 
and date; 

(3) ^ Insure alcoholic breath simulator ther- 
mometer shows proper operating temper- 
ature and insure simulator is properly 
cormected to instrument; 

[4] f^ Press "START TEST"; 
^ f4^ When "INSERT CARD" appears, in- 
sert test record; 



NORTH CAROLINA REGISTER 



407 



PROPOSED RULES 



(6) Enter appropriate information (keyboard 
instrument onlv); 

(7) f^ Insure mstrument displays expected 
results from the alcoholic breath simulator; 

[%X {^ When "PLEASE BLOW" appears, 

collect breath sample; 
[22 f^ When "PLEASE BLOW" appears, 

collect breath sample; 

(10) f% WTien test record ejects, remove and 
record times and results. 

If the alcohol concentrations differ by more 
than 0.02, a third or subsequent test shall be ad- 
ministered as soon as feasible by repeating steps 
(1) through f%r Q0]_ 

Statutory Authority G.S. 20-139. 1(b). 

.0351 PREXENTIVE M.AINTENANCE: 
INTOXILVZER: MODEL 5000 

The preventive maintenance procedures for the 
Intoxilyzer Model 5000 to be followed at least 
once during every 30 days are; 
( 1 1 Verify alcoholic breath simulator ther- 
mometer shows proper operating temper- 
ature and msure simulator is properly 
connected to instrument; 
(2) f+^ Verify mstrument displays proper time 

and date; 
02 ^ Press "START TEST"; 
(42 f4i When "INSERT CARD" appears, in- 
sert test record; 

(5) Enter appropriate information (keyboard 
instrument onlv); 

(6) kM Verify mstrument displays exp>ected re- 
sults from the alcoholic breath simulator; 

121 (^ When "PLEASE BLOW" appears, 

coUect breath sample; 
(82 {=h When "PLEASE BLOW" appears, 

collect breath sample; 
(9) fS^ When test record ejects, remove and 

record simulator results; 
(lOl (-% Repeat steps ( 1 ) through f8^ (9); 

(11) (-4^+ \'enfy alcoholic breath simulator sol- 
ution 15 bemg changed every 44 J_5 days or 
after 25 tests, whichever occurs first. 

A signed copy of the preventive maintenance 
checklist shall be kept on file for at least three 
years. 

Statulon Authority G.S. 20-139. Kb). 
CHAPTER 8 - HEALTH: PERSONAL HEALTH 

SLBCHAPTER 8D - CHILDREN'S SPECIAL 

HEALTH SERVICES: DEVELOPMENTAL 

DISABILITIES BRANCH 

SECTION .0200 - GENER.\L POLICIES 



.0204 SPONSORED CLINICS 

(a) Various types of sponsored clinics, with the 
partiapation of at least one rostered physician, 
will be conducted periodically throughout the 
State of North Carolina. ?j*^ initial diagnootio 
vioito peF oupportod modiool condition wi^ h^ 
Qvoilablo te aU ohildron rogordlooo e^ ooonomio 

Statutory Authority G.S. I30A-I24. 

SECTION .0700 - ROSTERS 

.0701 QLALIFICATIONS 

f*^ ¥i» phyoioion applioont fof Mi rootonng 
otatuo muot fee a rooidont ef North Carolina, li- 
oonood \» praotioo modioino » tke stat e , havo 
hospital privilogoo i» tfee oommuruty »f hio hor 
praotioo, be board oortifiod m » opocialty with 
podiatrio training m t^^at Dpecialty, aA4 moot (^ 
applioablo ontoria si t^ i\monoan Aoadomy ef 
Podiatrioo isf tket- opocialty. 

ffe^ Thoro shall be Vw» oatogorioo ei rost e red 
phyoioiano undor Children o Spociol Hoalth Sef- 

f4^ A fully rootorod physician wiii havo met- 
att^ke roquifomonto set- forth » Paragraph 
fftf ei tfei* Ptulo. Phyoioions rost e rod by 
tfee program prior te- ti*e dete ef implo 

foyy roGtorod; 
fS) A phyoioian may be oonditionolly rootorod 

oomo goographio rogion. A oonditionolly 
rootorod phyoicion iihoU moot eA ©f ifee fe- 
quiromonts se4 forth m Paragraph <-a4 ^ 
a feliy rootorod phyoioian. OKo e pt fef Ae 
roquiromontD (ka^ a phyoioian be board 
certifi e d »f moot (fee applioabl e criteria e4 
tfee i\monoan j\oademy ef Podiatnoo fef 
y*a* opocialty. Howovor, the phyoicion 
ohall poooooo podiatno oxporionoo ii^ a 
opocialty a»4 provide sor i 'iooo necoooary 
fof the eafe »f ohildron ift tkat goographio 
rogion. ¥be status ef ti*e conditionally 
rostered physician ohoU be ro' i 'iowed o^ory 

Childron'o Special Health Sonicoo shall havo 
wntton policioo govoFrung tfee rost e nng procooo. 

(a) There shall be two categories of rostered 
phvsicians under Children s Special Health Ser- 
vices: 

( 1) In order to be accorded full rostering sta- 
tus, an applicant must be a resident of 
North Carolina, licensed to practice med- 
icine in the state, have hospital pnvileges 
in the community of his her practice, and 
be board -certified in pediatncs. Physi- 



408 



I^ORTH CAROLINA REGISTER 



PROPOSED RULES 



dans who are not board-certified m pe- 
diatncs may be fully rostered if they are 
board-certified in a specialty with pediatric 
training in that specialty, and: 

(A) meet the applicable membership criteria 
of the American Academy of Pediatrics 
for that specialty, or 

(B) meet substantially equivalent creden- 
tialing requirements for a pediatric sub- 
specialty in a specialty. 

(2) A physician may be conditionally rostered 
if there is no fuUv rostered physiaan in the 
same geographic region. A conditionally 
rostered physician shall meet all of the re- 
quirements set forth m Paragraph (a)(1) 
of this Rule for a fully rostered physician, 
except for the requirements that a physi- 
cian be board-certified or meet the appli- 
cable membership criteria of the American 
Academy of Pediatrics for that specialty. 
However, the physician shall possess pe- 
diatric experience in a speaaltv and pro- 
vide services necessary for the care of 
children in that geographic region. The 
status of the conditionally rostered physi- 
cian shall be reviewed every three years. 
(b) Physicians rostered by the Program prior 

to the date of implementation of this Rule shall 

be considered fuUy rostered. 

Children's Special Health Services 



shall 
written policies governing the rostering 



have 
process. 

Statutory Authority G.S. I30A-I24. 

CHAPTER 10 - HEALTH: ENVIRONIMENTAL 
HEALTH 

SUBCHAPTER lOD - WATER SUPPLIES 

SECTION .1600 - WATER QUALITY 
STANDARDS 

.1624 ORGANIC CHEMICALS OTHER THAN 
TTHM: SAMPLING AND ANALYSIS 

(e) Analysis made to determine compliance 
with 10 NCAC lOD .1639(a) shall be conducted 
as follows: 

(1) Ground-water systems shall sample at 
points of entry to the distribution system 
representative of each well after any ap- 
plication of treatment. Ground-water 
systems shall must sample every three 
months for one year for each entry point 
to the distribution system except as pro- 
vided in Paragraph (e)(6)(i) of this Rule; 
sampling shall be conducted at the same 
location or a more representative location 
each quarter. Surface water systems shall 



sample at points in the distribution system 
located beyond any point of treatment 
application. Surface water systems 4»li 
must sample each source every three 
months except as provided in Paragraph 
(e)(6)(ii) of this Rule, campling Sampling 
shall be conducted at the same location 
or a more representative location each 
quarter for both surface and ground water 
systems. If a ground or surface system 
draws water from more than one source 
and sources are combined before distrib- 
ution, the system shall sample at an entry 
point to the distribution system during 
periods of normal operating conditions. 

(2) All community water systems and non- 
transient, non-community water systems 
serving more than 10,000 people shall an- 
alyze samples beginning no later than 
June 1, 1988. All community water sys- 
tems and non-transient, non-community 
water systems serving from 3,300 to 
10,000 people shall analyze samples be- 
giiming no later than the quarter which 
begins January 1, 1989. All other com- 
munity and non-transient, non-commu- 
nity water systems shall analyze samples 
begjiming no later than the quarter which 
begins January 1, 1991. 

(3) The department or the United States 
Environmental Protection Agency may 
require confirmation samples for positive 
or negative results. If a confirmation 
sample(s) is required, then the sample 
result(5) shall be averaged with the first 
sampUng result and the average used for 
the compliance determination in accord- 
ance with (e)(7) of this Rule. The de- 
partment may delete results of obvious 
sampling errors from this calculation. 

(4) Analysis for vinyl chloride is required 
only for ground water systems that have 
detected one or more of the following 
two-carbon organic compounds: Tri- 
chloroethylene, Tetrachloroethylene, 
1 ,2-dichloroethane, 1,1,1 -trichloroethane, 
cis- 1 ,2-dichloroethylene, 

trans- 1 ,2-dichloroethylene, or 

1,1-dichloroethylene. The analysis for vi- 
nyl chloride is required at each distrib- 
ution or entry pxjint at which one or more 
of the two-carbon organic compounds 
were found. If the first analysis does not 
detect vinyl chloride, the department may 
reduce the frequency of vinyl chlonde 
monitoring to once every three years for 
that sample location or other sample lo- 
cations which are more representative of 



NORTH CAROLINA REGISTER 



409 



PROPOSED RULES 



the same source. Surface water systems 
may be requu^ed to anal>'ze for vmyl 
chJonde at the discretion of the depart- 
ment. 
(5) The department or individual public wa- 
ter systems may composite up to five 
samples for one or more public water 
systems. Compositing of samples is to 
be done in the laboratory by the proce- 
dures listed in this Subparagraph. Sam- 
ples shall be analyzed within 14 days of 
collection. If any organic contaminant 
listed m 10 NCAC iOD .1639(a) is de- 
tected in the onginal composite sample, a 
sample from each source that made up the 
composite sample shall be reanalv'zed in- 
dividually within 14 days from samphng. 
The sample for reanalysis cannot be the 
onginal sample but can be a duplicate 
sample. If duplicates of the original sam- 
ples are not available, new samples shall 
be taken from each source used in the or- 
iginal composite and analyzed for volatile 
organic chemicals. Reanalysis shall be 
accomplished withm 14 days of the sec- 
ond sample. To composite samples, the 
followmg procedure shall be applied: 
(i) To composite samples pnor to GC 
analysis: 

(A) .-\dd 5 ml or equal larger amounts 
of each sample (up to 5 samples are al- 
lowed) to a 25 ml glass synnge. Special 
precautions shaU be made to mamtain 
zero headspace in the syringe. 

(B) The samples shall be cooled at 4°/C 
during this step to minimize volatiliza- 
tion losses. 

(C) Mix well and draw out a 5-nil aliquot 
for analysis. 

(D) Follow sample introdu^ n, purging, 
and desorption steps des«.rr>ed in the 
method. 

^E) If less than five samples are used for 
compositing, a proportionately smaller 
syringe may be used. 
(u) To composite samples prior to GC/MS 

analysis: 

(.■\) Inject 5-ml or equal larger amounts 
of each sample (up to 5 samples are al- 
lowed) into a 25-ml purging device us- 
mg the sample introduction technique 
descnbed m the method. 

(B) The total volume of the sample m the 
purging device shall be 25 ml. 

(C) Purge and desorb as described \n the 
method. 



(6) The monitoring frequency for sampling 

specified in Paragraph (e)(1) of this Rule, 

shall be as follows: 
(i) For ground water systems: 

(A) When volatile organic chemicals are 
not detected in the first sample (or any 
subsequent samples that may be taken) 
and the system is not vulnerable as de- 
fmed in Paragraph (e)(6)(iv) of this 
Rule, monitoring may be reduced to 
one sample and shall be repeated every 
five years. 

(By When volatile organic chemicals are 
not detected in the first sample (or any 
subsequent sample that may be taken) 
and the system is vulnerable as defmed 
in Paragraph (e)(6)(iv) of this Rule, 
monitormg of one sample must sbali 
be repeated every 3 years for systems 
with more than 500 connections, and 
monitoring of one sample must shall 
be repeated every 5 years for systems 
with 500 connections or less. 

(C) If volatile organic chemicals are de- 
tected in the first sample (or any subse- 
quent sample that may be taken), 
regardless of vulnerability, momtonng 
shall be repeated ever>' 3 months, as re- 
quired under Paragraph (e)(1) of this 
Rule. 
(ii) For surface water systems: 

(A) When volatile organic chemicals are 
not detected in the first year of quarterly 
samphng (or any other subsequent 
sample that may be taken) and the sys- 
tem is not vulnerable as defmed in Par- 
agraph (e)(6)(iv), monitoring is only 
required when the department deems it 
necessary. 

(B) When volatile organic chemicals are 
not detected in the first year of quarterly 
sampling, (or any other subsequent 
sample that may be taken) and the sys- 
tem is v-ulnerable as defmed m Para- 
graph (e)(6)(iv) of this Rule, 
monitormg shall be repeated every 3 
years for systems with more than 500 
connections and monitoring shall be 
repeated every 5 years for systems with 
500 connections or less. 

(C) When volatile organic chemicals are 
detected in the fu-st year of quarterly 
sampling (or any other subsequent 
sample that may be taken), regardless 
of \-ulnerability, momtoring shall be re- 
peated even,' 3 months as required un- 
der Paragraph (e)(1) of this Rule. 



410 



SORTH CAROLINA REGISTER 



PROPOSED RULES 



(iii) The department may reduce the fre- 
quency of monitoring to once per year for 
a groundwater system or surface water 
system detectmg volatile organic chemi- 
cals at levels consistently less than the 
maximum contaminant level for three 
consecutive years. 

(iv) Vulnerability of each public water sys- 
tem shall be determined by the depart- 
ment based upon an assessment of 
previous monitoring results, the number 
of persons served by public water system, 
proximity of a smaller system to a larger 
system, proximity to conmiercial or in- 
dustrial use, disposal, or storage of volatile 
synthetic organic chemicals, and pro- 
tection of the water source. 

(v) A system is deemed to be \ailnerable for 
a period of 3 years after any positive 
measurement of one or more contam- 
inants listed in either 10 NCAC lOD 
.1639(a) or .1638(d) and (h) except for 
trihalomethanes and other demonstrated 
disinfection by-products. 

(7) Compliance with 10 NCAC lOD .1639(a) 
shall be determined based on the results 
of running annual average of quarterly 
sampling for each sampling location. If 
one location's average is greater than the 
maximum contaminant level, then the 
system shall be deemed to be out of 
compliance. If a public water system has 
a distnbution system separable from other 
parts of the distribution system with no 
interconnections, only that part of the 
system that exceeds any maximum con- 
tammant level as specified in 10 NCAC 
lOD .1639(a) will be deemed out of com- 
pliance. The department may reduce the 
public notice requirement to that portion 
of the system which is out of compliance. 
If any one sample results would cause the 
annual average to be exceeded, then the 
system shall be deemed to be out of 
compliance immediately. For systems 
that only take one sample per location 
because no volatile organic chemicals 
were detected, compliance shall be based 
on that one sample. 

(8) Analyses made to determine compliance 
with this Paragraph shall be made m ac- 
cordance with methods adopted by the 
United States Environmental Protection 
Agency and codified as 40 C.F.R. 
141.24(g)(10) which are hereby adopted 
by reference in accordance with G.S. 
1 SOB- 14(c). A list of these methods is 



available from the Public Water Supply ' 
Branch, Environmental Health Section, 
Division of Health Services, P. O. Box 
2091, Raleigh, NC 27602-2091. 
(9) TTie department may accept momtoring 
data collected after January 1, 1983, for 
purposes of compliance, if the data is 
consistent with the other requirements in 
(e) of this Rule. The department may use 
that data to represent the initial monitor- 
ing if the system is determined by the de- 
partment not to be vulnerable under the 
requirements of this Rule. In addition, 
the results of the United States Environ- 
mental Protection Agency's Ground Wa- 
ter Supply Survey may be used in a 
similar manner for systems supplied by a 
smgle well. 
(10) The department may increase required 
monitoring where necessary to detect var- 
iations within the system. 

oonnootions may oomply m^ (k« moni 
tormg roquiromonts bv oonding » letter \^ 
tk# doportmont opooifymg tfeat \k^ oyotom 
\% available f»f oompling. ^>« i xunplos 
may be seirt te tbe dopartmont unlooo *» 
roquootod. ¥h« lottor muot be seat t« the 

(f) The department may deterrmne compliance 
or initiate enforcement action based upon ana- 
I>"tical results and other information compiled by 
the department's sanctioned representatives and 
agencies. 

Authority G.S. I30A-3I5: P.L. 93-523; 40 C.F.R. 
141. 

.1633 PUBLIC NOTIFICATION 

REQLIREMENTS (REPEALED) 

Authority G.S. I30A-315; P.L. 93-523; 40 C.F.R. 
141. 

.1638 SPECIAL MOMTORING FOR 
ORGANIC CHEMICALS 

(a) All commumty and non-transient, non- 
commumty water systems shall begin monitoring 
for the contaminants listed in Paragraph te^ (d) 
in this Rule as follows: 

(1) A system sen'mg more than 10,000 per- 
sons shall begin monitoring no later than 
June 1, 1988. 

(2) A system serving from 3,300 to 10,000 
persons shall begin monitoring no later 
than the quarter beginning January 1, 
1989. 



NORTH CAROLINA REGISTER 



411 



PROPOSED RULES 



(3) A system serving less than 3,300 shall be- 
gin monitoring no later than the quarter 
beginmng January 1, 1991. 

(b) Surface water systems shall sample in the 
distnbution system representative of each water 
source or at entn points to the distribution sys- 
tem after anv application of treatment; the mini- 
mum number of samples is one year of quarterly 
samples per water source. Ground water systems 
shall sample at points of entry to the distribution 
system representative of each well after any ap- 
plication of treatment; the minimum number of 
samples is one sample per entry point to the dis- 
tnbution system. 

(g) Pubhc water systems may use monitoring 
data coUected any time after January 1, 1983, 
provided the monitoring program was consistent 
with the requirements of this Rule. In addition 
the results of the U.S. Environmental Protection 
Agency's Ground Water Supply Survey may be 
used for systems supplied by a single well. 

(i) A water supplier for a community water 
system or non-transient, non-community water 
system serving fewer than 150 service con- 
nections may comply with this Rule by sending 
a letter to the department stating that its system 
is available for sampling. The water supplier 
shaU not send samples to the Department unless 
requested to do so by the Department. 

(k) The Department or a water supplier mav 
composite up to five samples when monitoring 
for substances m Paragraphs (d) and (h) of this 
Rule. 

Authority G.S 130A-3I5; P.L. 93-523; 40 C.F.R. 
141. 

.1640 REPORTING FOR ORGAMC 
CHEMICALS 

(d) The water supplier shall notify persons 
served by the system of the availability of the re- 
sults of sampling by including a notice in the first 
set of water bills issued after the receipt of the 
results, or bv wntten or newspaper notice, withm 
three months. The notice shall identify a pyerson 
and telephone number to contact for information 
on the monitonng results. For surface water 
SNStcms. public notice is required only after the 
first quarter s monitoring and shaU mclude a 
statement that additional monitonng wdl be 
conducted for three more quarters with the re- 
sults available upon request. 

Authority G.S. I30A-3I5: P.L. 93-523: 40 C.F.R. 
141. 

.1642 PI BLIC NOTICE 



(a) The supplier of water shall provide notice 
to consumers served by a public water system 
when the system fails to comply with a ma.xi- 
mum contaminant level or treatment technique 
established by this Subchapter or which fails to 
comply with the requirements of any schedule 
prescribed pursuant to a variance or exemption 
granted under this Subchapter as follows: 
(1) For a community water system: 

(A) Notice shall be given by publication m 
a daily newspaper of general circulation in 
the area served by the system as soon as 
possible, but in no case later than 14 days 
after the violation or failure. If the area 
is not served by a daily newspaper of 
general circulation, notice shall instead be 
given by publication in a weekly newspa- 
per of general circulation serving the area; 
and 

(B) In addition, notice shall be given by 
mail delivery (by direct mail or with the 
water bill) or by hand delivery, no later 
than 45 days after the violation or failure. 
Notices shall be repeated at least once ev- 
ery three months for as long as the vio- 
lation or failure exists. The Department 
may waive the requirements for mail or 
hand delivery if it determines that the 
supplier of water has corrected the vio- 
lation or failure within the 45-day period. 
The Department will make the waiver in 
writing and within the 45-day period. 

(C) WTien the area of the community water 
system is not served by a daily or weekly 
newspaper of general circulation, notice 
shall be given within 14 days after the vi- 
olation or failure by hand delivery or by 
continuous pxDsting in conspicuous places 
within the area served by the system. 
Posting shall continue for as long as the 
violation or failure exists. Notice by hand 
delivery shall be repeated at least once 
every three months for as long as the vio- 
lation or failure exists. 

(D) For violations of the maximum con- 
taminant levels of contaminants specified 
by the Department as posing an acute nsk 
to human health and for violation of the 
maximum contammant level for mtrate 
as defmed m 40 C.F.R. §141.1 1(b) and 
determined according to 40 C.F.R. 
§141. 23(d) which are hereby adopted by 
reference pursuant to G.S. 1 508- 14(c), 
notice shall be given by furnishing a copy 
of th» notice to the radio and television 
stations serving the area of the commumty 
water system as soon as possible but in 



412 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



no case later than 72 hours after the vio- 
lation. 
(2) For a non-community water system notice 
shall be given within 14 days after the vi- 
olation or failure by hand delivery or by 
contmuous posting in conspicuous places 
within the area served by the system. 
Posting shall continue for as long as the 
violation or failure exists. Notice by hand 
delivery shall be repeated at least once 
every three months for as long as the vio- 
lation or failure exists. 
(b) The supplier of water shall provide notice 
to consumers served by a public water system 
when the supplier fails to perform monitoring 
required by this Section, fails to comply with a 
testing procedure established by this Subchapter 
or is subject to a variance or an exemption 
granted under this Subchapter, as follows: 

(1) For a community water system: 

(A) Notice shall be given within three 
months of the violation by publication in 
a daily newspaper of general circulation in 
the area served by the system. If the area 
is not served by a daily newspaper of 
general circulation, notice shall instead be 
given by publication in a weekly newspa- 
per of general circulation serving the area; 
and 

(B) In addition, after publication notice 
shall be given by mail delivery (by direct 
mail or with the water bill) or by hand 
delivery at least once every three months 
for as long as the violation exists or a 
vanance or exemption remains in effect. 

(C) When the area of the community water 
system is not served by a daily or weekly 
newspaper of general circulation notice 
shall be given withm three months of the 
violation or the granting of the variance 
or exemption, by hand delivery or by 
continuous posting in conspicuous places 
within the area served by the system. 
Posting shall continue for as long as the 
violation exists or a variance or exemption 
remains in effect. Notice by hand delivery 
shall be repeated at least once every three 
months for as long as the violation exists 
or the vanance or exemption remains in 
effect. 

(2) For a non-community water system notice 
shall be given within three months of the 
violation or the granting of the variance 
or exemption, by hand delivery or by 
contmuous posting in conspicuous places 
within the area ser^'ed by the system. 
Posting shall continue for as long as the 
violation exists, or a variance or ex- 



emption remains in effect. Notice by 
hand delivery shall be repeated at least 
once every three months for as long as the 
violation exists or a variance or exemption 
remains in effect. 
(3) In lieu of the requirements of Paragraphs 
(b)(1) and (2) of this Rule the supplier of 
water, at the discretion of the Department, 
may provide less frequent notice for minor 
monitonng violations as defmed by the 
Department, if EPA has approved the 
Department's application for a program 
revision under 40 C.F.R. §142.16. Notice 
of such violations shall be given no less 
frequently than annually. 

(c) The supplier of water for a community 
water system shall give a copy of the most recent 
public notice for any outstanding violation of any 
maximum contaminant level, or any treatment 
technique requirement, or any variance or ex- 
emption schedule to all new billing units or new 
hookups prior to or at the time service begins. 

(d) Each notice required by this Rule shall 
pro\ade a clear and readily understandable expla- 
nation of the violation, any p>otential adverse 
health effects, the population at risk, the steps 
that the public water system is taking to correct 
such violation, the necessity for seeking alterna- 
tive water supplies, if any, and any preventive 
measure the consumer should take until the vio- 
lation is corrected. Each note shall be conspicu- 
ous and shall not contain unduly technical 
language, unduly small print, or similar problems 
that frustrate the purpose of the notice. Each 
notice shall include the telephone number of the 
owner, operator, or designee of the pubbc water 
system as a source of additional information 
concerning the notice. Where appropriate, the 
notice shall be multi-lingual. 

(e) When providing information on potential 
adverse health effects requu-ed by Paragraph (d) 
of this Rule in notices of violations of maximum 
contaminant levels or treatment technique re- 
quirements, or notices of the grantmg or the 
continued existence of variances or exemptions, 
or notices of failure to comply with a variance 
or exemption schedule, the supplier of water shall 
include the language specified in 40 C.F.R. 
§141. 32(e) and (f) which is hereby adopted by 
reference pursuant to G.S. 1 506- 14(c). Copies 
of the required notice language may be obtained 
from the Public Water Supply Branch, Environ- 
mental Health Section, Dhvision of Health Ser- 
vices, Post Office Box 2091, Raleigh, North 
Carolma 27602-2091. 

(f) The Department may give public notice on 
behalf of the supplier of water if the Department 
complies with the requirements of this Rule. 



NORTH CAROLINA REGISTER 



413 



PROPOSED RULES 



However, the supplier of water remains legally 
responsible for ensuring that the requirements of 
this Rule are met. 

(g) The provisions of this Rule do not apply 
to 10 NCAC lOD .1619, .1620 and .1621(a). 

Authontv G.S. /30A-3/5: P.L. 93-523: 40 C.F.R. 
141. 

SECTION .2400 - ADMINISTRATIVE 
PENALTIES 

.2409 PAYMENTS: HEARING 

(a) Withm ^ 60 days after receipt of notifica- 
tion of a penalty assessment, the respondent 
must tender payment, or submit in writmg a re- 
quest for an administrative hearing. .■Ml appeals 
shall be made in accordance with G.S. 150B and 
10 NCAC IB. 

Statutory Authority G.S. l30A-22(f). 

SLBCHAPTER lOF - HAZARDOUS WASTE 
MANAGEMENT 

.0032 STANDARDS FOR OWNERS/ 

OPERATORS OF HWMF'S - PART 264 

(i) "Financial Requirements" contained m 40 
CFR 264.140 to 264.151 (Subpart H) have been 
adopted by reference in accordance with G.S. 
1508- 14(c), except that 40 CFR 264.143(a)(3), 
(a)(4), (a)(5), (a)(6), 40 CFR 264.145(a)(3), 
(a)(4), (a)(5), (a)(6), and 40 CFR 264.151(a)(1), 
Section 15 and 40 CFR 264151(h), are not 
adopted by reference. 

TTie following shall be substituted for the pro- 
visions of 40 CFR 264, 151(h) which are not 
adopted by reference. 

(h) A corporate guarantee, as specified in Sec- 
tions 264.143(f) or 264.145(f) or Sections 
2^ 5. 143(e) or 265.145(e) of this Chapter, must 
be worded as follows, except that mstructions in 
brackets are to be replaced with the relevant m- 
tormation and the brackets deleted: 

CORPOR.ATE GUARANTEE FOR 
CLOSURE OR POST-CLOSURE CARE 

Guarantee made this |date| bv [name of guar- 
anteeing entit\|, a business corporation organized 
under the laws of the State of (insert name of 
State], herem referred to as guarantor, to the 
North CaroUna Department of Human Re- 
sources (DHRi. obligee, on behalf of our sub- 
sidiar% [owner or operator] of [busmess address]. 



]Note: All requirements in this document refer- 



enced as 40 CFR 264 have been adopted in 
North Carolina as 10 NCAC lOF .0032. and all 
requirements referenced as 40 CFR 265 have 
been adopted in North Carolina as jO NCAC 

lOF .0033. 

Recitals 

\^ Guarantor meets or exceeds the finannal 
test criteria and agrees to comply with the 
reporting requirements for guarantors as 
specified m 40 CFR 264.143(f), 
264.145(f). 265.143(e), and 265.145(e). 

1 [Owner or operator] owns or operates the 
following hazardous waste management 
facilitv(ies) covered by this guarantee: 
[List for each facility: EPA Identification 
Number, name, and address. Indicate for 
each whether guarantee is for closure, 
post-closure care, or both] 

3^ "Closure plans" and "post -closure plans" 
as used below refer to the plans mam- 
tained as required by Subpart G of 40 
CFR Parts 264 and 265 for the closure 
and post -closure care of facilities as iden- 
tified above. 

4. For value received from ]owner or 
operator], guarantor guarantees to DHR 
that in the event that [owner or operator] 
fails to perform Imsert "closure," "post- 
closure care" or "closure and post-closure 
care"] of the above faalitv(ies) in accord- 
ance with the closure or post-closure 
plans and other permit or interim status 
requirements whenever required to do so^ 
the guarantor shall do so or establish a 
trust fund as specified in Subpart H of 40 
CFR Parts 264 or 265. as appUcable. in 
the name of [owner or operatorl m the 
amount of the current closure or post- 
closure cost estimates as specified in Sub- 
part H of 40 CFR Parts 264 and 265. 

5^ Guarantor agrees that if. at the end of anv 
fiscal year before termination of this 
guarantee, the guarantor fails to meet the 
fmancial test criteria, guarantor shall send 
withm 90 davs, bv certified mail, notice to 
DHR and to [owner or operator] that he 
mtends to provide alternate fmancial as- 
surance as specified in Subpart H of 40 
CFR Parts 264 or 265, as applicable, m 
the name of ] owner or operator]. Within 
120 davs after the end of such fiscal year, 
the guarantor shall establish such finanaal 
assurance unless |ov.Tier or operator] has 
done so. 

6_ The guarantor agrees to notify- DHR by 
certified mail, of a voluntary or mvolun- 



414 



SORTH CAROUNA REGISTER 



PROPOSED RULES 



7. 



tary proceeding under Title n_ (Bank- 
ruptcy). U.S. Code, naming guarantor as 
debtor, within _10 days after commence- 
ment of the proceeding. 
Guarantor agrees that within 30 days after 
bemg notified by DHR of a determination 
that guarantor no longer meets the fman- 
ciaJ test cnteria or that he is disallowed 
from contmuing as a guarantor of closure 
or post-closure care, he shall estabhsh al- 
ternate financial assurance as specified in 
Subpart H of 40 CFR Parts 264 or 265, 
as apphcable, in the name of [owner or 
operatorl unless [owner or operatorl has 
done so. 

Guarantor agrees to remain bound under 
this guarantee notwithstanding any or all 
of the following: amendment or modifica- 
tion of the closure or post-closure plan, 
amendment or modification of the permit, 
the extension or reduction of the time of 
performance of closure or post-closure, 
or anv other modification or alteration of 



10. 



11. 



an obligation of the owner or operator 
pursuant to 40 CFR Parts 264 or 265. 
Guarantor agrees to re mam bound under 
this guarantee for so long as [owner or 



operatorl must comply with the applicable 
fmancial assurance requirements of Sub- 
part H of 40 CFR Parts 264 and 265 for 
the above-listed facilities, except that 
guarantor may cancel this guarantee by 
sending notice by certified mail to DHR 
and to [owner or operatorl, such cancella- 
tion to become effective no earlier than 
120 davs after receipt of such notice by 
both DHR and [owner or operatorl, as 
evidenced by the return receipts. 

Guarantor agrees that if [owner or 
operator[ fails to provide alternate fman- 
cial assurance as specified in Subpart H 
of 40 CFR Parts 264 or 265, as applicable, 
and obtain written approval of such as- 
surance from DHR within 90 days after a 
notice of cancellation bv the guarantor is 
received by DHR from guarantor, guar- 
antor shall provide such alternate fmanaal 
assurance in the name of [owner or 
operator[. 

Guarantor expressly waives notice of ac- 
ceptance of this guarantee bv DHR or by 
[owner or operator[. Guarantor also ex- 
pressly waives notice of amendments or 
modification of the closure and/or post- 
closure plan and of amendments or mod- 
ifications of the facility permit(s). 



I hereby certify that the wording of this guar- 
antee IS identical to the wording specified m Sec- 
tion 264.151(h) of 10 NCAC lOF .0032(i) as such 
regulations were constituted on the date first 
above written. 

Effective date: 

[Name of guarantor! 

[Authorized signature for guarantor[ 

[Name of person signing[ 

[Title of person signingi 

Signature of witness or notary: 
(s) Appendices I through IX contained in 40 
CFR 264 have been <idopted by reference in ac- 
cordance with G.S. 150B- 14(c). 

Statutory Authority G.S. l30A-294(c). 

.0034 INTERIM STATUS STANDARDS FOR 
PERMITTING - PART 270 

(b) The following provisions for additional 
permitting requirements contained in 40 CFR 
270 (Subpart B, Permit Application) have been 
adopted by reference in accordance with G.S. 
150B-14(c). 

(1) 40 CFR 270.10, General Application 
Requirements; 

(2) 40 CFR 270.11, Signatories to Permit 
Applications and Rep>orts; 

(3) 40 CFR 270.12, Confidentiality of Infor- 
mation; 

(4) 40 CFR 270. 1 3, Contents of Part A of the 
Permit Applications; 

(5) 40 CFR 270.14, Contents of Part B 
General Requirements; 

(6) 40 CFR 270.15, Specific Part B Infor- 
mation Requirements for Containers; 

(7) 40 CFR 270.16, Specific Part B Infor- 
mation Requirements for Tanks; 

(8) 40 CFR 270.17, Specific Part B Infor- 
mation Requirements for Surface Im- 
poundments; 

(9) 40 CFR 270.18, Specific Part B Infor- 
mation Requirements for Waste Piles; 

(10) 40 CFR 270.19, Specific Part B Infor- 
mation Requirements for Incinerators; 

(11) 40 CFR 270.20, Specific Part B Infor- 
mation Requirements for Landfill Land 
Treatment Facilities; 

(12) 40 CFR 270.21, Specific Part B Infor- 
mation Requirements for Land Treatment 
Facilities Landfill; 

(13) 40 CFR 270.23 Specific Part B informa- 
tion requirements for miscellaneous units; 

(14) 40 CFR 270.29 Permit Demal; 

( 15) (-14^ The following are additional Sf)ecific 
Part B information requirements for all 
treatment, storage or disposal facilities: 



NORTH CAROLINA REGISTER 



415 



PROPOSED RULES 



(A) A description and documentation of the 
public meetines as required in 10 NCAC 
lOF .0032(q)('7); 

(B) A descnption of the hydrological and 
geological properties of the site including, 
as a minimum, flood plains, depth to wa- 
ter table, ground water travel time, sea- 
sonal and longterm groundwater level 
fluctuations, pro.ximity to public water 
supply watersheds, consolidated rock, soil 
pH. soil cation exchange capacity, soil 
characteristics and compxjsition and 
permeability, existence of cavernous be- 
drock and seismic activity, slope, mines, 
chmate, location and withdrawal rates of 
surface water users within the immediate 
dramage basin and well water users within 
a one rrule radius of the facility; water 
quality infonmation of both surface and 
groundwater within 1000 ft. of the facility, 
and a description of the local air quality: 

(C) A description of the facility's proximity 
to and potential impact on wetlands, en- 
dangered species habitats, parks, forests, 
wilderness areas, histoncal sites, mines, 
and air quality: 

(D) A descnption of local land use includ- 
ing residential, mdustnal, commeraal, re- 
creational, agncultural and the proximity 
to schools and airports: 

(E) A descnption of the proximity of the 
facility to waste generators and population 
centers, a descnption of the method of 
waste transportation: the comments of the 
local commumtN and state transportation 
authonty on the proposed route, and 
route safety. Comments should include 
profX)sed alternative routes and re- 
stnctions necessary to protect the public 
health: 

(Fl A description of facility aesthetic factors 
mcludmg visibility, appearance, and noise 
level: 

(G) A description of any other objective 
factors that the Department of Human 
Resources determines are reasonably re- 
lated and relevant to the proper sitmg and 
operation of the facility: 
16) f4-H The foUowmg are additional specific 
Part B information requirements for 
comprehensi\e hazardous waste treatment 
facihties: 

(A) A descnption of the local zoning sur- 
roundmg the facility: 

( B ) A descnption of the buffer zones sur- 
roundmg the facility: 

(C) A descnption of the availability of util- 
ities to the facility; 



(D) A description of the availability of avil 
defense services to the facility: 

(E) A descnption of the fire safety of the 
facility: 

(F) A description of access into the facility, 
and the existing and proposed road net- 
work around the facility: 

(G) The distance from the facility to the 
nearest polychlonnated biphenyl landfill 
facility and hazardous waste landfill facil- 
ity; 

(H) A description of the procedures that 
will be employed to ensure that hazardous 
waste shall not be stored for over 90 days 
prior to treatment or disposal; 

(I) A description of any other objective 
factors that the Department of Human 
Resources determines are reasonably re- 
lated and relevant to the proper siting and 
operation of the facility; 
(IT) f44^ The following are additional Specific 
Part B Information Requirements for 
Long-Term Retrievable Storage. Long- 
Term Storage Facilities or Hazardous 
Waste Landfills: 

(A) The owners and operators must provide 
the following information about the waste 
and underground storage of either a haz- 
ardous waste landfill or long-term storage 
facility: 

(i) Design drawings and specifications of 
the leachate collection and removal 
system; 

(ii) Design drawings and specifications 
of the artificial impervious liner: 

(iii) Design drawings and specifications 
of the clay or clay-like liner below the 
artificial Uner, and a description of the 
permeability of the clay or clay-like 
liner: 

(iv) A description of how hazardous 
wastes will be treated prior to place- 
ment m the faciHtv as required m 10 
NCAC lOF .0032(o)(2)(B). 

(B) Long-term retnevable storage facilities 
must provide design drawmgs and specifi- 
cations of the lightmg, cement floors, 
shelves, platforms, inspection passage- 
ways, ventilation system, momtoring sys- 
tem, and safety and secunty precautions, 
and a descnption of how wastes will be 
protected from the weather and where 
waste identification will be placed: 

( 18) (44t The following are additional Specific 
Part B Information requirements for Sur- 
face Imp>oundments: 



416 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(A) Design drawings and specifications of 
the Icachate collection and removal sys- 
tem: 

(B) Design drawings and specifications of 
all artificial impervious liners; 

(C) Design drawings and specifications of 
all clay or clay-like liners and a description 
of the clay or clay-like liner; 

(D) Design drawmgs and specifications that 
show that the facility has been constructed 
in a manner that wUl prevent landsUding, 
slippage, or slumping. 

(d) The folio wmg provisions for additional 
permitting requirements contained in 40 CFR 
270 (Subpart D, Changes to Permit) have been 
adopted by reference in accordance with G.S. 
150B-14(c). 

(1) 40 CFR 270.40, Transfer of Permits; 

(2) 40 CFR 270.41, Major Modification or 
Revocation and Reissuance of Permits; 

(3) 40 CFR 270.42, MtRe* Modifioationo ef 
Permits; Permit modification at the re- 
quest of the permittee; and 

(4) 40 CFR 270.43, Tennination of Permits. 

Statutory Authority G.S. l30A-294(c): 
l30A-295ia)(l) and (2). 



I8Q .0123. .0125 - .0134: and adopt rules cited 
as 10 SCAC MM .0617 - .0621: ISM .1410. 

1 he proposed effective date of this action is De- 
cember I, 1989. 

1 he public hearing will be conducted at 1 :00 
p.m. on August 9. 1989 at Holiday Inn State 
Capitol, 320 Hillsborough Street. Raleigh, A'.C. 
27603. 

K^omment Procedures: Any interested person 
may present his/her comments by oral presentation 
or by submitting a written statement. Persons 
wishing to make oral presentations should contact 
Julie Burton, Division of Mental Health, Mental 
Retardation and Substance Abuse Services. 325 
,V. Salisbury Street, Raleigh, N.C. 27611, (919) 
733-7971 by August 9, 1989. The hearing record 
will remain open for written comments from July 
3, 1989 through August 9, 1989. Written com- 
ments must be sent to the above address and must 
state the rule(s) to which the comments are ad- 
dressed. Fiscal information on these rules is also 
available from the same address. 

CHAPTER 14 - MENTAL HEALTH: GENERAL 



SLBCHAPTER lOH - INACTIVE HAZARDOLS 
SUBSTANCES AND WASTE DISPOSAL SITES 

SECTION .0200 - PRIORITIZATION SYSTEM 

.0203 SLRh \CE W.\TER MIGRATION 

(a) The potential for surface water contam- 
mation is based upon route characteristics, waste 
containment, and waste characteristics. The 
score for surface water migration is determined 
by multiplymg the score determined for route 
characteristics m Paragraph (b) by the score de- 
termined for waste containment in Paragraph (c) 
then multiplying that result by the score deter- 
rruned for waste characteristics in Paragraph (d) 
and dividing that result by 13.26. 14.82. 

Statutory Authority G.S I30A-3I0.I2. 



J\ otice is hereby given in accordance with G.S. 
150B-12 that the Commission for Mental Health, 
.Mental Retardation and Substance Abuse Services 
intends to amend rules cited as 10 SCAC I4K 
.0/03. .03/5. .0403: /4M .060/ - .0602, .0604, 
.0606. .0608 - .0609. .061/ - .06/6: /8J .07//; 
/8M .070/. .0704. .0^07, ./40I: 45H .0202: repeal 
rules cited as /O SCAC 14M .0603. .0605, .0607; 



SLBCHAPTER I4K - CORE LICENSURE RULES 

FOR MENTAL HEALTH: MENTAL 

RETARDATION AND OTHER 

DEVELOPMENTAL DISABILITIES: AND 

SUBSTANCE ABUSE FACILITIES 

SECTION .0100 - GENERAL INFORMATION 

.0103 DEFINITIONS 

(c) The foDowing terms shall have the mean- 
ings specified: 

(8) "Approved supported employment con- 
version plan" means a planned approach 
to changing the type of services delivered 
from A DAP facilitv-based to supported 
employment. Approval of the conversion 
plan IS the responsibility of the Regional 
Director of the Division in conjunction 
with the Area EHrector or his designee if 
the facility is operated by a contract 
agency of the area program or other ser- 
vice provider. The Division shall request 
involvement from appropnate personnel 
in the Division of Vocational Rehabili- 
tation in the re\'iew process. The request 
for approval of the supported employ- 
ment conversion plan shall include spe- 
cific wntten information in the following 



(A) number of chents to be moved into 
supported employment placements; 



NORTH CAROLINA REGISTER 



4i: 



PROPOSED RULES 



(B) types of supported employment models 
to b£ used: 

(C) timeframe for the conyersion period; 

( D) mtenm proposed facility staiTing pat- 
terns and responsibilities: and 

(E) proposed budget for conyersion plan. 
[2i t-^ ".-Vrea program" means a legally con- 
stituted public agency providmg mental 
health, mental retardation and substance 
abuse services for a catchment area desig- 
nated by the commission. For purposes 
of these Rules, the term "area program" 
means the same as "area authonty" as 
defmedm G.S. 122C-3. 

( 10) f% "Assessment" means a procedure for 
detemuning the nature and extent of the 
problem for which the individual is seek- 
mg service. 

(11) f44f "Atypical development" in children 
means those from birth to 60 months of 
age who demonstrate significantly atypical 
behavioral socioemotional, motor, or 
sensory development as manifested by: 

(A) Diagnosed hyperactivity, attention def- 
icit disorder or other behavioral disorders, 
or 

(B) Identified emotional behavioral disor- 
ders such as: 

(i) delay or abnormality m achievmg ex- 
pected emotional milestones, such as 
pleasurable mterest m adults and peers; 
ability to commumcate emotional 
needs, and ability to tolerate frus- 
trations. 

(ii) persistent failure to initiate or respond 
to most social interactions. 

(iii) fearfulness or other distress that does 
not respond to comfortmg by caregiv- 
e- 

(\\ indiscriminate sociability, e.g. exces- 
^ familiarity with relative strangers. 

(v) -If-injurious or unusually aggressive 
behavior, or 
(Cj Substantiated physical abuse, sexual 

abuse, or other environmental situations 

that raise significant concern regarding the 

child s emotional weU-bemg. 

( 12) f4-44 "Certified counselor" means an alco- 
holism, drug abuse or substance abuse 
counselor who is certified by the North 
Carolma Substance Abuse Professional 
Certification Board. 

(13) f44^ "Child" means a minor between birth 
and 12 years of age. 

(14) fy-^ "ChrorLcally mentally ill adult" me- 
ans an mdividual 1 8 years of age or older 
who, as a result of a mental disorder, ex- 
hibits emotional or beha\ioral functiorung 



which is so impaired as to interfere sub- 
stantially with his. her capacity to remam 
in the commumty without supportive 
treatment or services of a long-term or 
indefinite duration. In these persons, 
mental disability is severe and persistent, 
resultmg m long-term limitation of their 
functional capaaties for primary activities 
of daily living such as interpersonal re- 
lations, homemaking, self-care, employ- 
ment and recreation. 

( 15) f44^ "Client record" means a written ac- 
count of all services provided a client from 
the time of formal acceptance of the client 
by the facility until termination of ser- 
vices. This information is documented 
on standard forms adopted by the facility 
which are fded m a standard order. 

(16') f44} "Clinical" means having to do with 
the active direct treatment/habilitation of 
client. 

(P -44^ "Clinical staff member" means a 
professional who provides active direct 
treatment habilitation to a client. 

(18) f4^ "Clinical professional supervision" 
means regularly scheduled assistance by a 
qualified mental health professional, a 
qualified substance abuse professional or 
a qualified developmental disabilities pro- 
fessional to a staff member who is pro- 
viding direct, therapeutic intervention to 
a client or clients. The purpose of clinical 
sup)ervision is to ensure that each client 
receives appropnate treatment and or ha- 
bilitation which is consistent with ac- 
cepted standards of practice and the needs 
of the client. 

(19) fJ-8^ "Contested case" means an adminis- 
trative proceeding under G.S. 150B, Arti- 
cle 3, in which the nghts, privileges, or 
duties of a party(s) are required by law to 
be determined. 

(20) (44^ "Contract agency" means a legally 
constituted entity with which the area 
program contracts for a service(s) exclu- 
sive of intermittent purchase of service for 
an individually identified client. 

(21) f3^ "Declaratory rulmg" means a formal 
and binding interpretation as to: 

(A) the validity of a rule; or 

(B) the applicability to a given state of facts 
of a statute administered by the Depart- 
ment of Human Resources, or a rule or 
order of the Department of Human Re- 
sources. 

(22) f444 "Detoxification" means the physical 
withdrawal of an individual from alcohol 



418 



SORTH CAROLISA REGISTER 



PROPOSED RULES 



or other drugs in order that the individual 
can participate m rehabilitation activities. 

(23) f4^ "Developmentally delayed children" 
means those whose development is de- 
layed m one or more of the following ar- 
eas: cognitive development, physical 
development, language/ speech, self-help 
and psychosocial skills. The specific level 
of delay must be: 

(A) for children from birth to 36 months 
of age, documented by scores 1 Vx stand- 
ard deviations below the mean on stand- 
ardized tests in at least one of the above 
areas of development. Or, it may be do- 
cumented by a 20 percent delay on as- 
sessment instruments that yield scores in 
months; and 

(B) for children from 36 to 60 months of 
age, documented by test p>erformance two 
standardized deviations below the mean 
on standardized tests in one area of de- 
velopment or by p)erformance that is one 
standard deviation below the norm in two 
areas of development. Or, it may be do- 
cumented by a 25 percent delay in two 
areas on assessment instruments that yield 
scores in months. 

(24) (-3^ "DFS" means the Division of Facil- 
itv Services, 701 Barbour Drive, Raleigh, 
N.C. 27603. 

(25) f54+ "Direct care staff' means an individ- 
ual who provides active direct care, treat- 
ment or rehabilitation habilitation services 
to cliL-nts on a continuous and regularly 
scheduled basis. 

(26) f^ "Dispensing medication" means pre- 
paring and packaging a prescription drug 
or device in a container and labeling the 
container with information required by 
state and federal law. FiUing or refilling 
drug containers with prescription drugs 
for subsequent use by a client is "dis- 
pensmg". Providing quantities of unit 
dose prescription drugs for subsequent 
administration is "dispensing". 

(27) f^ "DMH MR SAS" means the Divi- 
sion of Mental Health, Mental Retarda- 
tion and Substance Abuse Services, 325 
N. Salisbury Street, Raleigh, N.C. 27611. 

(28) f^?^ "Documentation" means provision 
of written, dated and authenticated evi- 
dence of the delivery of client services or 
compliance with statutes or rules, e.g., 
entnes in the client record, policies and 
procedures, minutes of meetmgs, memo- 
randa, reports, schedules, notices and an- 
nouncements. 



(29) f3^ "Drug abuse" means psychoactive 
substance abuse which is a residual cate- 
gory for noting maladaptive patterns of 
psychoactive substance use that have 
never met the criteria for dependence for 
that particular class of substance (criteria 
delineated in DSM-III-R published by the 
American Psychiatric Association, 1400 
K Street, N.W., Washington, D.C. 20005 
at a cost of twenty-nine dollars and nine- 
ty-five cents ($29.95) for the soft cover 
edition and thirty-nine dollars and nine- 
ty-five cents ($39.95) for the hard cover 
edition.) 

(30) f39^ "Drug dependence" means psy- 
choactive substance dependence which is 
a cluster of cognitive behavioral, and 
physiologic symptoms that indicate that a 
person has impaired control of psychoac- 
tive substance use and continues use of 
the substance despite adverse conse- 
quences (criteria delineated in DSM-III-R 
published by the American Psychiatric 
Association, 1400 K Street, N.W., Wash- 
ington, D.C. 20005 at a cost of twenty- 
nine dollars and ninety-five cents ($29.95) 
for the soft cover edition and thirty-nine 
dollars and ninety-five cents ($39.95) for 
the hard cover edition.) 

(31) f4% "DWI" means driving while im- 
paired, as defined in G.S. 20-138.1. 

(32) f^44 "DWI substance abuse assessment" 
means a service provided to persons 
charged with or convicted of DWI to de- 
terrmne the presence of chemical depend- 
ency. The "assessment" involves a 
face-to-face interview with a substance 
abuse professional. 

(33) f^3) "Evaluation" means an assessment 
service which identifies the nature and ex- 
tent of an individual's problem through a 
systematic appraisal of mental, physical, 
behavioral, functional social, econormc 
and/or inteUectual resources of the indi- 
vidual, for the purposes of diagnosis and 
determination of the disability of the in- 
dividual and the most appropriate plan, if 
any, for services. 

(34) (-^ "First aid" means emergency treat- 
ment for injury or sudden illness before 
regular medical care is available. First aid 
includes artificial respiration, the Heimlich 
maneuver, or other Red Cross first aid 
techniques for relieving airway ob- 
struction, care of wounds and bums, and 
temporary administering of splints. 

(35) f44^ "Governing body" means those per- 
sons who by law, charter, £irticles of in- 



NORTH CAROLINA REGISTER 



419 



PROPOSED RULES 



corporation, partnership agreement, or 
other legally recognized manner have full 
legal authonty for the overall operation 
of the facility. 
(.16) (4^ "Heanng" means a contested case 
hearmg under G.S. 150B. Article 3. 

(37) (46^ "High risk children" means those 
from bulh to 36 months of age who: 

(A) have a diagnosed physical or mental 
condition which has a high probability of 
resultmg in developmental delay or atypi- 
cal development; 

(B) have significant atypical patterns of de- 
velopment (perceptual, sensorv', physical, 
behavioral, motor anomalies) that have a 
high probability of resulting m develop- 
mental delay or atypical development; or 

(C) have responded well to mtervention ef- 
forts but for whom there is evidenced that 
their contmued developmental progress 
cannot be assured without contmued in- 
tervention. 

(38) (t?^ "Hours of op>eration" means an indi- 
cation of the minimum operational hours 
that a service is expected to be available 
to chents, but not prohibiting the typical 
closing of a service to accommodate holi- 
days, vacations, staff development activ- 
ities and weather and facility-related 
conditions but taldng mto consideration 
the tvpe of ser^'ice beine provided. 

(39) <4«4 "ICF MR" (Intermediate Care 
Facility Mentally Retarded) means a fa- 
cility certified as ha\'mg met federal 
ICF MR requirements and which pro- 
vides 24-hour personal care, habilitation, 
developmental and supportive services to 
persons with mental retardation or related 
conditions. 

(40) f^ft+ "Incident" means any happening 
uhich is not consistent with the routine 
operation of the facility or the routme care 
of a client and that is likely to lead to ad- 
verse effects upon a client. 

(41 ) f4ft+ "Individual goal plan" (for clients 
with mental retardation or other develop- 
mental disabilities) means a wntten plan 
wfuch includes measurable, date-specific, 
short-range objectives which are assessed 
and developed or restated at least quar- 
terly based on the strengths and needs of 
the client and which identifies specific staff 
responsibilities and relates to the annual 
individual program plan. 

(42) W4^ "Individual program plan" (for cli- 
ents with mental retardation or other de- 
velopmental disabilities) which is 
sometimes referred to as an "habilitation 



plan," means a written plan which m- 
cludes long-range objectives for the client 
based on evaluations, observations and 
other client assessment data and which is 
implemented following admission of the 
client, and assessed and redeveloped at 
least annually from the date of placement. 
The individual program plan includes a 
wntten summary of the client's progress 
regarding previous program plans. 

(43) f4^ "Individual treatment plan" (for 
mental health/ substance abuse clients) 
means a plan of treatment for the client. 
The plan contains time-specific short and 
long term goals and strategies for imple- 
menting the goals, and identifies direct 
care staff responsible for the provision of 
treatment and rehabilitation services to 
the client. The mdividual treatment plan 
is synonymous with the mdividual service 
plan. 

(44) f4^ "Infant" means an individual be- 
tween birth and two years of age. 

(45) f44^ "Isolation time-out" means the re- 
moval of a client from positive reinforce- 
ment to a separate room from which exit 
is barred but which is not locked and 
where there is contmuous super-ision bv 
staff. 

(46) f4-i>-^ "Legend drug" means a drug that 
cannot be dispensed without a pre- 
scription. 

(47) f4^ "License" means a permit to operate 
a facility which is issued by DFS under 
G.S. 122C, -Article 2. A regular license 
may be issued for a penod not to exceed 
two years from the date of issue to a fa- 
cility which IS in compliance with all ap- 
plicable statutes and rules. A provisional 
license may be issued not to exceed six 
months to a person who is temporarily 
unable to comply with a rule or rules. 

(48) f4^ "Medication" means a substance re- 
cognized in the offiaal "Umted States 
Pharmacopoeia" or "National 
Formulary" mtended for use in the diag- 
nosis, mitigation, treatment or prevention 
of disease. 

(49) f4% "Minor client" means a person under 
18 years of age who has not been mamed 
or who has not been emancipated by a 
decree issued by a court of competent ju- 
risdiction or is not a member of the armed 
forces. 

(50) f4ftf "Neighborhood" - See "residential 
settmg". 

(51) f^©+ "Nurse" means a person licensed to 
practice in the State of North Carolma 



420 



SORTH CAROLINA REGISTER 



PROPOSED RULES 



either as a registered nurse or as a licensed 
practical nurse 

(52) (-S-H "Operator" means the designated 
agent of the governing body who is re- 
sponsible for the management of a licens- 
able facility. 

(53) f^ "Parent" means the biological or 
adoptive mother or father of a minor cli- 
ent. 

(54) (4^ "Physical examination" means the 
procedures used by a physician or physi- 
cian extender on behalf of a physician to 
determine the physiological and anatom- 
ical condition of the client. Physical ex- 
amination also means medical 
examination. 

(55) {SA^ "Physician extender" means a nurse 
practitioner or a physician assistant ap- 
proved to perform medical acts by the 
Board of Medical Examiners of the State 
of North Carolina. 

(56) {4^ "Preschool age child" means a child 
three through five years of age. 

(57) f44^ "Private facility" means a facility not 
operated by or under contract with an 
area program. 

(58) f^ "Program evaluation" means the 
systematic documented assessment of 
program activity to determine the effec- 
tiveness, efficiency and scope of the sys- 
tem under investigation, to defme its 
strengths and weaknesses and thereby to 
provide a basis for informed decision- 
making. 

(5Q) (4^ "Provider" means an mdividual, 
agency or organization that provides 
mental health, mental retardation or sub- 
stance abuse services. 

(60) f§^ "Psychiatric nurse" means an indi- 
vidual who is licensed to practice as a re- 
gistered nurse in the State of North 
Carolina by the North Carolina Board of 
Nursmg and who is a graduate of an ac- 
credited master's level program in psychi- 
atnc mental health nursing with two years 
of experience, or has a master's degree in 
behavioral science with two years of su- 
pervised cUnical experience, or has four 
years of expenence in psychiatric mental 
health nursing. 

(61) f6% "Psychiatric social worker" means an 
individual who holds a master's degree in 
social work from an accredited school of 
social work and has two years of clinical 
social work experience. 

(62) (4+f "Psychiatrist" means an individual 
who is bcensed to practice medicme in the 
State of North Carolina and who has 



completed an accredited training program 
in psychiatry. 

(63) (43) "Psychotherapy" means a form of 
treatment of mental illness or emotional 
disorders which is based primarily upon 
verbal or non-verbal communication with 
the patient. Treatment is provided by a 
trained professional for the purpose of re- 
moving or modifying existing symptoms, 
of attenuating or reversing disturbed pat- 
terns of behavior, and of promoting posi- 
tive personality growth and development. 

(64) (4^ "Psychotropic medication" means 
medication with the primary function of 
treatmg mental illness, personality or be- 
havior disorders. These medications in- 
clude, but are not limited to, 
antipsychotics, antidepressants, neurolep- 
tics, lithium and minor tranquilizers. 

(65) (44) "Qualified alcoholism professional" 
means an individual who is certified by 
the North Carolina Substance Abuse 
Professional Certification Board or who 
is a graduate of a college or university with 
a baccalaureate or advanced degree Ln a 
human service related field with doc- 
umentation of at least two years of super- 
vised experience in the profession of 
alcohobsm counseling. 

(66) (4^ "Qualified developmental disabilities 
professional" means an individual holding 
at least a baccalaureate degree in a disci- 
pline related to developmental disabilities, 
and at least two years of supervised habi- 
litative experience in workmg with the 
mentally retarded or otherwise develop- 
mentally disabled or holding a baccalau- 
reate degree in a field other than one 
related to developmental disabilities and 
having three years of supervised experi- 
ence in working with the mentally re- 
tarded or otherwise developmentally 
disabled. 

(67) (44) "Qualified drug abuse professional" 
means an individual who is certified by 
the North Carolina Substance Abuse 
Professional Certification Board or who 
is a graduate of a college or university with 
a baccalaureate or advanced degree in a 
human service related field with doc- 
umentation of at least two years of super- 
vised exp>erience m the profession of drug 
abuse counseling. 

(68) (4?) "Qualified mental health 
professional" means any one of the fol- 
lowing: psychiatrist, psychiatric nurse, 
practicing psychologist, psychiatric social 
worker, an individual with at least a mas- 



NORTH CAROLINA REGISTER 



421 



PROPOSED RULES 



ter's degree in a related human service 
field and two years of 5uper\'ised clmical 
cxpenence in mental health services or an 
individual with a baccalaureate degree in 
a related human semce field and four 
years of supervised clinical expenence in 
mental health services. 
(6'^) f6^ "Qualified nutntiomst" means an in- 
dividual who has a Master's degree in nu- 
tation, nutntion education or public 
health nutntion and who may or may not 
be a registered dietitian. 

(70) ir^^ "Qualified substance abuse profes- 
sional" means an individual who is: 

(A) certified by the North Carolina Sub- 
stance Abuse Professional Certification 
Board; or 

(B) a graduate of a college or university 
with a baccalaureate or advanced degree 
m a human service related field with doc- 
umentation of at least two years of super- 
vised expenence in the profession of 
alcoholism and drug abuse counseling. 

(71) PO^ "Registered dietitian" means an indi- 
vidual who has successfully completed a 
national examination for the Commission 
on Dietetic Registration and maintains 
registration with that commission through 
approved continuing education 
activities events. 

(72) fr-k "Rehabilitation" means training, care 
and speaalized therapies undertaken to 
assist a chent to reacquire or maximize 
lost skills and or functional abilities. 

(73) f?^ "Research" means inquiry involving 
a tnal or speaal observation made under 
conditions determined by the investigator 
to confirm or disprove an hypothesis, or 
to explicate some principle or effect. The 
term "research" as used in this document 
means research which is not standard or 
conventional; mvolves a tnal or special 
observation which would place the subject 
at nsk for mjury (physical, psychological 
or social injury), or mcrease the chance 
of disclosure of treatment: utilizes ele- 
ments or steps not ordmanly employed 
by qualified professionals treating similar 
disorders of this jx)pulation; or is a type 
of procedure that serves the purpose of 
the research only and does not mclude 
treatment designed primarily to benefit the 
individual. 

(74) fJ^ "Residential setting" means a living 
area or zone in which the primary purp>ose 
IS family residential livmg and which may 
be located m an area zoned either urban 
residential or rural. 



(75) f?4^ "Respite discharge" means that point 
in time when no additional incidents of 
respite service are antiapated and the cli- 
ent record is closed. 

(76) f34^ "Respite episode" means an uninter- 
rupted period of time during which. a cli- 
ent receives respite services. The episode 
may vary in length from one hour or less 
to one month. 

(77) f34> "Restraint" means the limitation of 
a client's freedom of movement by: 

(A) physical hold for the purpose of sub- 
duing the client; 

(B) "mechanical restraint" which is the use 
of mechanical devices for the purpose of 
controlling behavior including, but not 
limited to, cuffs, ankle straps, sheets, or 
restraining shirts; or 

(C) "protective restraint" which is the use 
of protective devices to provide support 
and safety for weak and feeble clients, or 
to prevent medically ill clients from re- 
moving intravenous tubes, indwelling 
catheters, cardiac monitor electrodes, etc. 
Such devices may include p>osey vests, 
geri-chairs, table top chairs or soft lies. 

(78) fW^ "Restrictive facility" means a facility 
which employs the use of mechanical re- 
straint or seclusion m order to restnct a 
client's freedom of movement. A judicial 
determination as specified m G.S. 122C- 
223 and G.S. 122C-232 is required for 
mmor clients and mcompetent adult cli- 
ents who are admitted to a restnctive fa- 
cility. 

(79) (5^ "Screening" means an assessment 
service which provides for a bnef face-to- 
face appraisal of each individual who pre- 
sents himself herself for services, in order 
to determine the nature of the individual's 
problem and his her need for ser\'ices. 
Screening may also include referral to 
other appropnate community resources. 

(80) f^?^ "Seclusion" means isolatmg a client 
in a separate locked room for the purpose 
of controlhng a client s behavior. 

(81 ) (-8^ "Secretary" means the Secretary of 
the Department of Human Resources or 
designee. 

(82) f84-^ "Severely physically disabled 
p)erson" means for the purpose of ADAP 
(Adult Developmental Activity Program) 
a person: 

(A) who has a severe physical disability 
which senously limits his functional ca- 
pabilities (mobility, communication, self- 
care, self -direction, work tolerance or 
work skills); 



422 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(B) who has one or more physical disabili- 
ties resulting from amputation, arthntis, 
blindness, cancer, cerebral palsy, cystic fi- 
brosis, deafness, heart disease, hemiplegia, 
hemophilia, respiratory or pulmonary 
dysfunction, multiple sclerosis, muscular 
distrophy, musculoskeletal disorders, neu- 
rological disorders (including stroke and 
epilepsy), paraplegia, quadriplegia, and 
other spinal cord conditions, sickle cell 
anemia and end stage renal disease; and 

(C) whose habilitation or rehabilitation can 
be expected to require multiple habili- 
tation or rehabilitation services over an 
extended period of time. 

(S3) (-&^ "Sheltered employment" means a fa- 
cility's provision of work and work train- 
ing by: 

(A) subcontracting from industries in the 
community and bringing work to the fa- 
cility to be performed; or 

(B) manufacturing its own products in the 
facility. 

Clients ser\'ed in a sheltered employment 
model are those who consistently achieve 
earning levels exceeding one-half of the 
minimum wage but who are not ready for 
independent employment activities. 

(84) fS^ "Staff member" means any individual 
who IS employed by the facility. 

(85) fA4+ "Sub'^tantially mentally retarded per- 
son" means for the purpose of ADAP a 
person who is mentally retarded to the 
degree of seriously hmiting his functional 
capabilities whose habilitation or rehabil- 
itation can be expected to extend over a 
period of time, and including: 

(A) moderately mentally retarded persons; 

(B) severely mentally retarded persons; 

(C) profoundly mentally retarded persons; 
or 

(D) mentally retarded persons with a han- 
dicappmg condition so severe as to lack 
the potential for employment at this time, 
either m a sheltered or competitive setting. 
In addition, such individuals must have a 
deficit m self-help, communication, so- 
cialization or occupational skills and be 
recommended by the vocational rehabili- 
tation counselor for consideration of 
placement in an ADAP. 

(86) fS^ "Support services" means services 
provided to enhance an individual's pro- 
gress in his primary treatment habilitation 
program. 

(87) f^ "Supported employment" means a 
day night ser\'ice which involves paid 
work in a job which would otherwise be 



done by a non-disabled worker. Sup- 
ported employment is earned out in an 
integrated work site where a small number 
of people with disabilities work together 
and where the work site is not imme- 
diately adjacent to another program- serv- 
ing persons with disabilities. It includes 
intensive involvement of staff workmg 
with the individuals in these integrated 
settings. 

(88) (*?) "Toddler" means an individual be- 
tween one and three years of age. 

(89) f8^ "Treatment" means the process of 
providing for the physical, emotional, 
psychological and social needs of clients 
through services. 

(90) (4^ "Twenty-four hour facility in which 
medical care is an integral component" 
means a facility in which: 

(A) the medication needs of clients may be 
evaluated, medication prescribed and lab- 
oratory tests ordered to assist in the diag- 
nosis, treatment and/or monitoring of 
problems associated with the mental 
health, mental retardation or other devel- 
opmental disabilities or substance abuse 
disorder(s) of clients; and 

(B) proper referral of the client is made to 
medical specialists when needed. 

Statutory Authority G.S. J22C-3; I22C-26: 
1438- 147. 

SECTION .0300 - FACILITY .WD PROGRAM 
MANAGEMENT 

.0315 INDIVIDLAL TREATMENT/PROGRAM 
PLAN 

(d) Mental Retardation Developmental Disa- 
bility Facilities and Sheltered Workshops: 

(1) Individual program plans shall be devel- 
oped and implemented within 30 days of 
admission to all facilities with the excep- 
tion of respite care programs. The plan 
shall be reviewed at least quarterly and 
assessed and redeveloped at least annually. 
For clients in ADAP -facility based mod- 
els and sheltered workshop placements, 
the annual assessment shall include a re- 
view to determine the need for referral to 
Vocational Rehabilitation or other ser- 
vices. For clients in ADAP-Supported 
Employment- Long-Term Support, it shall 
include an indication of the level of need 
for long-term support activities and the 
specific type of support required. Pro- 
gram plans shall provide the basis for the 
development of individual goal plans. 



NORTH CAROLINA REGISTER 



423 



PROPOSED RULES 



Program plans shall provide a systematic 
approach to the habilitation of the client 
and substantiate the appropriateness of 
the habUitation goals. Program plans 
shall be developed in partnership with cli- 
ents or individuals acting in behalf of cli- 
ents. Chnical responsibility for the 
development and implementation of pro- 
gram plans shall be designated. In addi- 
tion, m facilities servmg infants, toddlers 
or preschool age children, except for those 
providing respite services, the program 
plan shall include: 

(A) goals for the client's family as well as 
goals for the chent; 

(B) catena and timeframe to be used to 
determine progress towards goals; 

(C) planned habiHtation procedures related 
to the goals: 

(D) a statement of the specific ser\'ices to 
be provided to meet the identified client 
and family needs, and the initiation dates, 
frequency and method of service delivery; 

(E) the designation of the staff member re- 
sponsible for case management ser\'ices; 
and 

(F) the plans for transition into ser\'ices 
which are the responsibility of the N.C. 
Department of Public Instruction. 

(2) IndiNidual goal plans shall be developed 
m the appropnate developmental and vo- 
cational skill areas. Goal plans shall be 
assessed on a quarterly basis in all facilities 
with the exception of de\elopmental 
disabibty behavior disorder group homes 
wherem goal plans shall be assessed on a 
monthly basis. Such assessment shall ad- 
dress the client's progress or lack of pro- 
gress toward meeting the plan and review 
of the plan for appropriateness of estab- 
lished goals. Individual goal plans are not 
required for clients in supervised inde- 
pendent livmg, alternative family living, 
sheltered workshops and .ADAP clients in 
supported employment. Individual goal 



plans are also not required for A DAP cli- 
ents tari^cted for supported employment 
or those in the intensive training penod 
or the long-term support period of sup- 
ported employment. To be targeted as a 
sypportcd employment client, the chent 
must have been determined in writing to 
be appropnate for supported employment 
by representatives of the facility, the local 
unit ot^ the Division of Vocational Reha- 
biLtation Services and the .-Vrea Develop- 
mental Disabibties Specialist of the .Area 



Mental Health, Mental Retardation and 
Substance Abuse Program or his designee. 

Statutory Authority G.S. I22C-26: MSB- 1 47. 

SECTION .0400 - PHYSICAL PLANT 

.0403 COMPLIANCE WITH BLILDING CODE 
REQLIREMENTS 

(g) In addition to Building Code requirements 
specified in (b) and (c) of this Rule, new facilities 
specified in (1), (2), (3) and (4) of this Paragraph 
shall meet the requirements of the current edition 
of Volume I, Section 405, Business Occupancy 
(B) of the N.C. State Building Code as follows: 
(1) Mental retardation developmental disabil- 
ity facilities: adult developmental activity 
programs -facility-based models for indi- 
viduals with substantial mental retarda- 
tion, severe physical disabilities or other 
substantial developmental disabilities; 

Statutory Authority G.S. I22C-26: 1438- 147; 
I SOB- 14(c). 

SLBCHAPTER 14M - LICENSLRE RULES FOR 

MENTAL RETARDATION/DEVELOPMENTAL 

DISABILITIES FACILITIES 

SECTION .0600 - ADLLT DEVELOPMENTAL 

ACTIVITY PROGRAMS FOR INDIMDLALS 

WITH SI BST.\NTIAL MENTAL 

RETARDATION: SEVERE PHYSICAL 

DISABILITIES OR OTHER SUBSTANTIAL 

DEVELOPMENTAL DISABILITIES 

.0601 INTRODUCTION 

(a) An adult developmental activity program 
(ADAP) is a day night service which provides 
organized developmental activities for adults with 
substantial mental retardation, severe physical 
disabilities or other substantial developmental 
disabilities to prepare the individual to live and 
work as independently as possible. The activities 
and services of an ADAP are designed to adhere 
to the pnnciples of normalization and commu- 
nity mtegration aimed at increasing age-appro- 
priate actions, images and appearance ot the 
individual. 

(hi An .ADAP offers a diverse variety of spe- 
cific services and activities. These include voca- 
tional evaluation. vocational traming. 
remunerative employment, personal and com- 
munity livmg skill development, adult basic edu- 
cation and long-term support, follow-up and case 
management. Support serv'ices to chents' fami- 
lies and consultation with the clients' employers 
and other mvolved agenaes may also be pro- 
vided. The amount of time devoted to these ar- 
eas vanes considerably dependmg on the needs 



424 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



of the clients sen'ed. ft* amount ef te»« 4e- 
sotod to tht ' oo aroQb vonoo conjiiJerablv dopond 
«e upon tk« noodD ef ti*e cliontD oonod. TTiodo 
' jor i 'ico i .' i »ft4 acti' i 'itioo includ e t^ foUovving: 

fi-^ porsonol (*«4 oo mm unity living olullo d«- 
volopmont; 

(-^ adult baoio oducation; 

(4^ trainmg » ti*« cogniti' i ' e . conrununi cation 
aft4 motor olulls; 

f4^ k ' i ' jur e km© utiluatioft T 

fS^ vocational evaluation ttR4 adjuotm e nt; a«4 

f4f work acti' i 'ity traimng. 

i i vith othor irn'olvod agoncioo »»¥ afe» b« pfe- 
vided. The Rules contained m this Section are 
applicable to three specific models of A DAP 
services as follows: 
Qi ADAP - Facility Based. 



plicable to the individual model as indicated in 
the Rile catchlines. Whatever the model pro- 
vided, it is the ADAP service that is subiect to 
been sure, not the business or organization where 
the cbent is placed for work. 

Statutory Authority G.S. I22C-26: 1438- 147. 

.0602 COMPLIANCE WITH OTHER RLLES 

An ADAP shall be subject to licensure under 
G.S. 122C, Article 2 unless provided by a sh e l 
torod workshop facility subject to the rules of the 
North Carolina Division of Vocational Rehabili- 
tation Services. 

Statutory Authority G.S. I22C-26; 1438- 1 47. 

.0603 HOLRS OF OPERATION (REPEALED) 



The majontv of the ADAP activities in 

this model, whether vocational or devel- Statutory Authority G.S. I22C-26: 1438-147. 



in 



01 



opmental in nature, are carried out on the 
premises of a site specilicallv designed for 
this purpose. 

■ADAP ; Supported Employment. 
The only ADAP services provided by the 
operator are those related to supported 
employment. .All of the training activities 
in this model occur in the settmg where 
the client actually works or lives, not in a 
specialized facility maintained by the op- 
erator. 

AD.\P - Supported Employment ^ Long- 
Term Support. 

This includes both the intensive training 
and long-term support phase. Clients 
served m this model have successfully 
completed the mtensive initial trairung 
phase of supported employment which is 
sponsored by and the responsibility of the 
Division for Vocational RehabUitation 
Services. They are receiving those long- 
term support services which are targeted 
towards mamtenance m the job and resi- 
dential settmg and mdependent function- 
ing in the community. These are services 
which are the responsibility of the Divi- 
sion. Examples of such long-term sup- 
port services include "refresher" 
vocational traimng to ensure that existmg 
training in new [ob 
commumtv 
living skill training, and consultation to 



job skills are not lost 

performance expectations. 



other employees, employers, and families, 

and residential program staff, 
(d) A smgle facihtv mav operate more than one 
of these models. Rules .0602. .0604. .0606 and 
-(>6(IK through .0617 of this Section are appbcable 
to aU three models. The remainmg rules are ap- 



.0604 PHYSICAL PLANT REQUIREMENTS 

(a) If the site is maintained by the ADAP, the 
following are applicable: 

(1) f«^ Each facility site shall be inspected an- 

nually by an outside safety consultant 
with written documentation and fol- 
low-up on recommendations; 

(2) fb-f Each facility site shall be designed and 

equipped to promote the trainmg, em- 
ployment and adult status of clients; 

(3) {^ Each facility work site shall eliminate 

architectural barriers which prohibit ac- 
cess to the buildmg and use of equipment 
and facilities; 

(4) (4^ Each facility site shall provide adequate 

toilet facilities and drinking fountams for 
clients; and 

(5) Each site shall have designated space for 
classroom activities. 

mamtamed bv another indi- 



(b) If the site 15 

vidual, business or organization 



the ADAP shall 

determine that the site reflects safe working con- 
ditions for that client prior to and durmg place- 



ment of the client at the site. 

Statutory Authority G.S. I22C-26: 1438-147. 

.0605 PROVISION FOR CLASSROOM SPACE 
(REPEALED) 

Statutory Authority G.S. I22C-26: 1438^147. 

.0606 PROGRAM DIRECTOR/COORDINATOR 

(b) The program director coordinator shall be 
at least a high school graduate or equivalent with 
three years of experience in mental r e tardation 
developmental disabilities programming, but 
preferably a baccalaureate degree with at least 



NORTH CAROLINA REGISTER 



425 



PROPOSED RULES 



one year of expenence in montaJ rotordation de- 
velopmental disabilities programming. 

Slatuiory Auihoriiy G.S. I22C-26; I43B-I47. 

.0607 CLIENT/STAFF RATIO (REPEALED) 
Staiuton- Authority G.S. I22C-26: I43B-147. 

.0608 CLIENT EVALLATOR 

a* » cli e nt ^valuator. Each facility shall have 
e\aluation services available for all clients. 



( b ) The person! s) providing evaluation services 
cliL'nt o' . aluator shall have a high school diploma, 
but preferably a college degree. ftft4 ohall have 
compk't(>d » frr« dft¥ moonio ^ training program 

ef » another training pro gam appro^'od fe^r ii*» 
DMH MR Si\S. fhev shaU be approved for 
such responsibilities by the pnvile.eing procedures 
approved bv the area authontv or its contract 
agencies. 

Statutory Authority G.S. I22C-26: I43B-I47. 

.0609 ACTIMTIES AND SERVICES 

(b) Community integration activities shall be 
provided on an individual basis but in groups »f 
no larger than two to three persons whenever 
possible. 

(c) .Acti\ities and services shall be aimed at in- 
creasmg age-appropnate actions, images and ap- 
pearance of the clients. 

(d) Activities and services shall be directed to- 
ward the preparation of substantially hand- 
icapped adults to live as mdependently as 
possible. 

Statutory Authority G.S. 122C-26; I43B-I47. 

.061! SAFETY COMMITTEE 

If the site is maintained by the AD.AP. the fol- 
lowing are applicable: 

( 1 1 (-*+ .A sal'ety committee compnsed of staff 
members and clients roprooontati'roo shall be 
appomted to review accident reports and to 
momtor the AD.AP for safety: 

(2) (-b-> The safety committee shall meet at least 
quarterly; and 

(3) f«4 Minutes shall be kept of all meetings and 
submitted to the director coordmator with 
recommendations for needed changes. 

Statutory Authority G.S. 122C-26: I43B-I47. 

.0612 BLSINESS PRACTICES 



(a) The followmg are applicable if the .AD.AP 
seeks or receives remuneration for goods or ser- 
vices provided to another individual, organization 
or busmess: 

( 1) fft+ Supplies, materials or tools, if provided 

by the ADAP, shall be identified as a se- 
parate amount in the bid price; 

(2) (¥> Wages paid to ADAP clients shall be 

on a piece rate or hourly commensurate 
wage; 

(3) f«^ Each client involved in productive work 

shall receive a written statement for each 
pay penod which indicates gross pay, 
hours worked and deductions; and 

(4) (4> Prices for goods produced in the ADAP 

shall be equal to or exceed the cost of 
production (including commensurate 
wages, overhead, tools and matenalsi. 
fb) If the client is an employee of another in- 
dividual, organization or busmess, the .AD.AP 
shall review client earnings information on at 
least an annual basis to ensure appropnateness 
of pay rates and amounts. 

Statutory Authority G.S. I22C-26; I43B-147. 



.0613 ACCIDENT REPORTING 

If the site is maintained bv the .AD.AP. 



there 

shall be a wntten plan oholl tee ootabliohod for the 
reportmg of all accidents that occur dunng 
.ADAP activities, whether or not they give nse to 
mjunes requmng medical treatment. The acci- 
dent report shall contam the followmg informa- 
tion; 

( 1) identity of persons involved; 

(2) place of accident; 

(3) tune of accident; 

(4) name of responsible supervisor; 

(5) description of the accident; and 

(6) emergency services rendered. 

Statutory Authority G.S. I22C-26; I43B-147. 

.0614 PROMOTION OF CLIENTS' RIGHTS 

Clients shall be counseled concerning their 
nghts and responsibilities a* partioipant - j » *^ 
facility in such matters as wages, hours, working 
conditions, social secunty, redress for mjury and 
the consequences of their own tortuous or un- 
ethical conduct. 

Statutory Authority G.S. I22C-26: /43B-/47. 

.0615 LSE OF PLBLIC TRANSPORTATION 
BY CLIENTS 

Clients served by the ADAP shall be encour- 
aged to use public transportation or other non- 
facilitv transportation options, if available. 



426 



l^ORTH CAROLINA REGISTER 



PROPOSED RULES 



Siatuwry Authority G.S. I22C-26: I43B-I47. 

.0616 SLSPtNSIONS AND DISMISSALS 

If the work site is managed by the ADAP, the 
follovvmg are applicable: 

( 1) fft^ Each ADAP shall establish written cri- 
tena and procedures for client suspensions 
and dismissals; 

(2) (4H Dismissal shall be the result of a stafT 
assessment which shall include, but not be 
limited to, those behavior(s) judged to be 
harmful to self or others; and 

(3) fef Suspensions shall be the result of a staff- 
ing process and shall be for a specified time 
period and include programmatic assessment 
and accommodations made with all suspen- 
sions reported to the referral or sponsoring 
agency if the agency has maintained an ac- 
tive relationship with the client since the 
time of referral. 

Statutory Authority G.S. 122C-26; I43B-I47. 

.0617 H.WDBOOK 

(a) Each ADAP shall have a client handbook 
including, but not limited to, information about 
services and activities. 

(b) The client handbook shall be written in a 
manner comprehensible to clients and reflective 
of adult status 

(c) Each client shall be given a handbook, and 
the handbook shall be reviewed with the client. 

Statutory Authority G.S. /22C-26; I43B-I47. 

.0618 FACILITY BASED ADAP: HOLRS OF 
OPERATION 

ADAP services shall be available for client at- 
tendance at least six hours per day (exclusive of 
transportation time), five days f>er week, 12 
months per year unless closed in accordance with 
procedures outlined m the manual (APSM 75-1) 
"/Vrea Program Budgeting and Procedures Man- 
ual". 

Statutory^ Authority G.S. I22C-26: 1 438- 1 47. 

.0619 FACILITY BASED ADAP: CLIENT/ 
STAFF RATIO 

(a) Each ADAP shall maintain an overall direct 
service ratio of at least one full-time or full-time 
equivalent direct service staff member for each 
ten or fewer clients. 

(b) For facilities having an approved supported 
employment conversion plan as defmed in 10 
NCAC 14K. .0103, this standard will not apply 
for a maximum of ten clients or 20 percent of a 



facility's average daily enrollment, whichever is 
greater. 

Statutory Authority G.S. I22C-26: I43B-I47. 

.0620 SLPPORTED EMPLOYMENT: LONG- 
TERM SUPPORT ADAP: CLIENT 
STAFF RATIO 

In group supported employment models, such 
as the mobile crew or enclave, each ADAP shall 
maintain an overall direct service ratio of at least 
one full-time equivalent direct service staff mem- 
ber for each eight or fewer clients. In individual 
placement models, such as job coach, the 
amount of staff contact time per client shall be 
commensurate with client needs and the require- 
ments of the work setting. 

Statutory Authority G.S. I22C-26; I43B-I47. 

.0621 ADMISSIONS CRITERIA AND 
PROCEDURES 

(a) Each ADAP shall have an admissions 
committee. 

(b) A pre-admission staffmg shall be held for 
each client considered for admission to the 
ADAP. During the staffmg, the committee shall 
consider information available regarding the cli- 
ents medical, psychological, social, and voca- 
tional histories. 

(c) Results of the pre-admission staffmg shall 
be documented and forwarded to the referral or 
sponsoring agency. A representative of the 
AD.'XP admissions committee shall notify the 
cbent. 

Statutory Authority G.S. I22C-26; I43B-I47. 

CHAPTER 18 - MENTAL HEALTH: OTHER 
PROGRAMS 

SUBCHAPTER 18J - AREA PROGRAM 
MANAGEMENT STANDARDS 

SECTION .0700 - QUALITY ASSURANCE 

.071 1 PRIVILEGING OF ALL PROFESSIONAL 
STAFF 

(d) Professionals providing habilitation and fa- 
mily support services to infants and toddlers with 
or at risk for developmental delays or atypical 
development and their families shall be privilet;ed 
according to the procedures outlined in the ma- 
nual (.\PSM 120-1 ), "Regulations for Pnvilegmg 
Professionals Working With Infants and Tod- 
dlers With or At Risk for Developmental Dela\s 
or Atypical Development". This manual is 
adopted by reference in accordance with G.S. 
150B-14(c). 



NORTH CAROLINA REGISTER 



427 



PROPOSED RULES 



Statutory Authority G.S. J22C-//7; /22C-/55; 
I43B-I4^; 20 L'SC 1471. 

SL BCHAPTER ISM - REQUIRED SERVICES 

SECTION .0700 - DE\ ELOPMENTAL DAY 

SERVICES FOR PRESCHOOL CHILDREN 

WITH DEVELOPVIENTAL DISABILITIES 

OR DELAYS OR AT HIGH RISK FOR 

MENTAL RETARDATION. DEVELOPMENTAL 

DISABILITIES OR DELAYS 

.0701 INTRODUCTION 

.\ developmental day senice is a day night ser- 
vice which provides individual habilitative pro- 
gramming for pre-school children with 
developmental disabilities or delays or at high 
risk for mental retardation, developmental disa- 
bilities or delays or atypical development m spe- 
cialized hcensed child care centers. It is designed 
to meet developmental needs of the children such 
as self-help, foie an4 groso motor, physical, lan- 
guage and oommunitfation, speech, and cognitive 
and oooial psychosocial skills m order to facilitate 
their functioning m a less restnctive environment, 
as well as to meet child care needs of families. 
It also offers family training and support and case 
management. 

Statutory Authority G.S. /43B-/4''. 

.0704 STAFF REQUIREMENTS 

(d) A minimum of one certified teacher who 
holds certification in special education, early 
childhood education or elementary education 
shall be emplo\ed for each 20 children or less. 
When infants and toddlers are served, the pro- 



fessional responsible for fulfilLmg this require- 
ment shall be privileged according to the 
procedures outlined in the manual (APS.M 
120-1 ). "Regulations for Privilegmg Professionals 
Working With Infants and Toddlers With or At 
Risk for Developmental Oelavs or Atypical De- 
velopment". This manual is adopted by refer- 
ence m accordance with G.S. 150B-14(c). 

(c) II inlants und e r •!-& montho ef ag» are serv ed. 
a minimum of one direct care staff member shall 
be on duty for each three infants. 

(f) Assessment of the child to deterrrune devel- 
opmental delay, developmental disability, atypi- 
cal development or high risk for these conditions 
shall be performed by aft appropnaloly cr e di^n 
tial e d profoor . ional whoce troirung quolifioo 
him hor te aor . oos childron » A* ddolopmontol 
ftwft Bi ooncom. Stondardigod t«**T rating C i coJoo. 

procoduroii iheti mcx)t aoooptablo propoc i od otand 
ctf4^ C i hall ^ u&cd v» documont (^ natur e aft4 
sovonty ef t^ probloms nocoooitatmg mtor 



s'ontion. professional privileged accordmg to 
procedures outlined m the manual (APSM 
120-1 ) "Regulations for Pnvilegmg Professionals 
Working With Infants and Toddlers With or At 
Risk for Developmental Delays or Atypical De- 
velopment", whose trainmg qualifies him her to 
assess children m the developmental area of con- 
cern. 

Statutory Authority G.S. I43B-147. 

.0707 INDIMDUAL PROGRA.M PLANS AND 
GOAL PLANS 

(a) Individual pwogram plans, with individual 
quarterly goal plans, shall be developed with the 
parent for each child. 

(b) Individual goal plans shall address the de- 
velopmental skill areas of self help, fis* aft4 gross 
motor, physical, language and oommumoation. 
speech, cognitive and oooial psychosocial skills 
as mdicated by needs identified in the child as- 
sessment process and parental priorities. 

(c) Each review of the child's and parent's 
progress shall be conducted bv the Develop- 
mental Day staff and the child s parents. 

(d) When infants, toddlers or preschoolers are 
served, mdividual parent program plans with m- 
dividual quarterly goal plans shall be developed 
with the parents or legally responsible person of 
the children served in areas mdicated bv needs 
identified m the family assessment process This 
process mvolves gathermg information about fa- 
mily strengths and needs related to their ability 
to enhance their child's development 

(e) Standardized tests, ratmg scales, develop- 
mental profiles and other mstruments and pro- 
cedures that meet acceptable professional 
standards shall be used to document the nature 
and severity of the problem necessitatmg mter- 
vention. 

Statutory Authority G.S. I22C-5I: I43B-I47. 

SECTION .1400 - EARLY CHILDHOOD 

INTERVENTION SERVICES (ECIS) FOR 

CHILDREN WITH MENTAL RETARDATION 

OR AT HIGH RISK FOR MENTAL 

RETARDATION OR OTHER 

DEVELOPMENTAL DISABILITIES OR DELAYS 

.1401 INTRODUCTION 

(a) .'\n early childhood intervention service 
(ECIS) is a periodic service designed to promote 
the developmental growth of a child who is 
mentally retarded or otherwise developmentaUy 
disabled or delayed or who has atypical develop- 
ment or is at high risk for mental retardation, 
developmental disabilities or delays or atypical 
development. In addition, it provides families 



428 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



with support and information on child-rearing 
skills and management, and ser%ices and re- 
sources available to the child and family. The 
service provides, on a regularly scheduled basis, 
comprehensive assessment and prescriptive de- 
velopmental programming in such areas as cog- 
nitive, language and communication, physical, 
self-help, and psychosocial skill development in 
the client's home which may be supplemented 
by indi\idual or group services at other sites. 
This service provides case-speafic and general 
follow-up and consultation to other preschool 
programs. Case management is also a compo- 
nent of this service. 

(b) The primary methodology of service deliv- 
ery is penodic (usually weekly) home visits which 
may be supplemented by group or individual ac- 
tivities at sites other than the child's home. 

Statutory Authority G.S. I43B-I47; 20 USC 
1471. 



velopment", whose training qualifies him her to 
assess children m the developmental area of con- 
cern. 



Statutory Authority G.S. 
1471. 



I43B-I47; 20 CSC 



.1404 MEDICAL STATEMENT 

(a) Each staff member, student intern, regular 
volunteer, substitute staffer other individual who 
works directly and on a continuous basis with 
children shall submit to the program at the time 
of initial approval and annually thereafter a 
medical statement from a licensed physician. 

(b) The medical statement may be in any 
written form but shall be signed by the physician 
and indicate the general good physical health of 
the individual and the lack of evidence of active 
tuberculosis and communicable diseases. 

(c) The program shall keep the most recent 
medical statement on file. 



.1402 PROGRAM OrRECTOR/COORDINATOR 

Each ECIS shall have a designated 
director coordinator who holds at least a bacca- 
laureate degree in a field related to developmental 
disabilities, or is registered to practice as a regis- 
tered nurse m the State of North Carolina, and 
who has at least one year's experience in services 
for infants or toddlers with or at nsk for devel- 
opmental delays or atypical development. This 
includes, but is not limited to, fields such as early 
childhood education, child development, or sf>e- 
cial education. 

Statutory Authority G.S. I22C-5I; /43B-/47,- 20 
ISC 1471. 

.1403 INTERDISCIPLINARY ECIS STAFF 

(a) At least one member of the ECIS staff shall 
be an individual who holds a degree in education 
or early childhood development. 

(b) The disciplines of social work, physical 
therapy, occupational therapy and medicine shall 
be represented on the staff in response to the 
documented needs of the children and families 
served. These disciplines may be represented by 
staff members, consultant staff, or through 
agreements with staff of other agencies. 

(c| .Assessment of the child to determine de- 
velopmental delay, developmental disability, 
atypical development or high risk for these con- 
ditions shall be performed by an appropriately 
privileged professional privileged according to the 
procedures outlined in the manual (APS.M 
120-1) "Regulations for Pnvileging Professionals 
Working With Infants and Toddlers With or At 
Risk for Developmental Delays or Atypical De- 



Statuton! Authority G.S. I22C-5I: 1438- 147: 20 
use 1471. 

.1405 INDIVIDLAL PROGRAM PLANS AND 
GOAL PLANS 

(a) Individual program plans, with indisidual 
quarterly goal plans, shall be developed with the 
parent for each child. 

(b) Individual quarterly goal plans shall address 
the developmental areas of self help, physical, 
language and speech, cognitive, and psychosocial 
skills as indicated by needs identified m the child 
assessment process and parental pnonties. 

(c) Each review of the child's progress shall be 
conducted by the ECIS staff and the child's par- 
ents. 

(d) Individual parent program plans with indi- 
vidual quarterly goal plans shall be developed 
with the parents or legally responsible person of 
the children served or in areas indicated by needs 
identified in the family assessment process. This 
process involves gathering information about fa- 
mily strengths and needs related to theu" ability 
to enhance their child's development. 

(e) Standardized tests, rating scales, develop- 
mental profiles and other instruments and pro- 
cedures that meet acceptable professional 
standards shall be used to document the nature 
and severity of the problem necessitating inter- 
vention. 

Statutory Authority G.S. I22C-5I: I43B-I47: 20 
use 1471. 

.1406 LANGLAGE/COMMLNICATION AND 
HEARING SERVICES 



NORTH CAROLINA REGISTER 



429 



PROPOSED RULES 



Each ECIS shall provide or secure 
language communjcation and hearing services for 
each child in need of such service. This ser\'ice 
shall include assessment, programming, pre- 
scnption, monitoring and specialized diagnostic 
services. 



Statutory Authority G.S. /22C-5/; I43B-I4' 
LSC 1471. 



20 



.1407 PHYSICAL THER.APY SERVICES 

Each ECIS shall provide or secure physical 
therapy services for each child in need of such 
ser%ices. These services shall include assessment, 
programming, prescription momtonng, and spe- 
cialized diagnostic services. 

Statutory Authority G.S. 122C-5I; 1438-/47; 20 
LSC 1471. 

.1408 PARENT COLNSELING SERVICES 

Each ECIS shall provide or secure counseling 
services for parents in need of such services. 

Statutory' Authority G.S. I22C-5I: /43B-/47; 20 
LSC /4"/. 

.1409 BEHAVIOR MANAGEMENT TRAINING 
FOR PARENTS 

Each ECIS shall provide or secure training in 
behavior management techniques for parents m 
need of such services. 

Statutor\' Authorttv G.S. 122C-5I: /43B-/4^: 20 
LSC 1471. 

.1410 FOLLOW ALONG CONTACTS 

At least semi-annual follow along contacts for 
a period of not less than one year shall be made 
on behalf of children who have been discharged 
from the ECIS. 

Stalulon.' .Authority G.S. I22C-5I; I43B-I47; 20 
LSC 1471. 

SL BCfLAF'TER 18Q - GROLP HOMES FOR 

ADl LTS \MTH MENTAL RETARDATION OR 

OTHER DEVELOPMENTAL DISABILITIES 

SECTION .0100 - EARLY CHILDHOOD 

INTERN ENTION SER\ ICES (ECIS) FOR 

CHILDREN WITH MENTALLY RETARDATION 

OR AT HIGH RISK FOR MENTAL 

RETARDATION OR OTHER 

DEVELOPMENTALLY DISABILITIES OR 

DELAYS 

.0123 INTRODLCTION (REPEALED) 

Statutory- Authority G.S. 143B-147. 



.0125 PROGRAM DIRECTOR/COORDINATOR 

(REPEALED) 
.0126 INTERDISCIPLINARY ECIS STAFF 

(REPEALED) 
.0127 MEDICAL STATEMENT (REPEALED) 
.0128 INDIVIDLAL PROGRAM PLANS AND 

GOAL PLANS (REPEALED) 
.0129 LANGLAGE/COMMLNICATION AND 

HEARING SERVICES (REPEALED) 
.0130 PHYSICAL THERAPY SERVICES 

(REPEALED) 
.0131 PARENT TRAINING GOAL PLANS 

(REPEALED) 
.0132 PARENT COLNSELING SERVICES 

^REPEAL EDI 
.0133 BEHAVIOR MANAGEMENT TRAINING 

FOR PARENTS (REPEALED) 
.0134 FOLLOW ALONG CONTACTS 

(REPEALED) 

Statutory Authority G.S. 122-55.5; 1433-147. 

CHAPTER 45 - NORTH CAROLINA DRLG 
COMMISSION 

SUBCHAPTER 45H - DRLG TREATMENT 
FACILITIES 

SECTION .0200 - SCHEDULES OF 
CONTROLLED SUBSTANCES 

.0202 SCHEDULE I 

(d) Hallucinogenic Substances. Unless specif- 
ically excepted or unless listed in another sched- 
ule, any material, compound, mixture or 
preparation which contains any quantity of the 
following haUucmogemc substances, or which 
contains any of their salts, isomers and salts of 
isomers, whenever the existence of such salts, 
isomers and salts of isomers is possible within the 
specific chemical designation (for purposes of this 
Paragraph only, the term "isomer" includes the 
optical, position and geometric isomers): 
f54} 1 m e thylammor g x (al60 

Icnown a# 2 ajruno 1 

mothyl 5 phonyl 2 

oxajolmo) 1590 

(26) <rirh Thiophene analog 

of phencycUdine Some 

trade or other names: 

l-ll-(2-thienyl)- 

cyclohexyl|-piperidine: 

2-thienyl analog of 

phencvclidine; TPCP, 

TCP.' 7470 

(f) Stimulants. Unless specifically excepted or 
unless listed m another schedule, any material, 
compound, mixture, or preparation which con- 
tains any quantity of the following substances 
havms a stimulant effect on the central nervous 



4i0 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



system, including its salts, isomers, and salts of 
isomers: 

(1) Fenethylline 1503 

(2) (plus mmus)cis-4- 
meth\laminorex [(plus 
minus icis-4.5-dihvdro- 
4-methvl-5-phenvl-2- 
oxa7.olamine| (also known 



as 2-amino-4-methvl-5- 
phenvl-2-oxazoline) 
(3) f^ N-ethylamphetarrune 



1590 
1475 



Statutory Authority G.S. 90-88: 90-89: I43B-I47. 

TITLE 15 - DEPARTMENT OF N.ATLRAL 

RESOURCES AND COM.ML^SITY 

DEVELOPMENT 

1\ otice is hereby given in accordance v^'ith G.S. 
I SOB- 1 2 that the \RCD - Emironmental Man- 
agement Commission intends to amend rules cited 
as IS SCAC 28 .0216 and .0309. 

J he proposed effective date of this action is 
March I, 1990. 

1 he public hearing will be conducted at ^00 
p.m. on .August 2. 1989 at Montgomery Commu- 
nity College, Auditorium. Old Biscoe Road. Trov, 
SC. 



Co 



ommeni Procedures: .411 persons interested in 
this matter are invited to attend. Comments, 
statements, data, and other information may be 
submitted in writing prior to, during, or within 30 
days after the hearing or may be presented orally 
at the hearing. Oral statements may be limited 
at the discretion of the hearing officer. Submittal 
or written copies of oral statements is encouraged. 
For more information contact Steve Zoufaly, Di- 
vision of Environmental Management. P.O. Box 
2'68^. Raleigh. SC 27611. {919) 733-S083. 

CHAPTER 2 - EWIRONMENTAL 
MANAGEMENT 

SLBCIIAPTER 2B - SURFACE WATER 
STANDARDS: MONITORING 

SECTION .0200 - CLASSIFICATIONS AND 

WATER Ql AI.ITV STANDARDS APPLICABLE 

TO SLRKACE WATERS OF NORTH CAROLINA 

.0216 OUTSTANDING RESOURCE WATERS 

(c) Listmg of Waters Classified ORW with 
Specific Actions. Waters classified as ORW with 
specific actions to protect exceptional resource 
values are listed as foUows: 



(1) Specific actions to protect the outstanding 
resource values of the Listed waterbodies 
include no new discharges, no flow ex- 
pansions of existing discharges, and 
stormwater controls for all development 
activities requiring a Sediment Erosion 
Control Plan as follows: 
Low Density Option: Developments 
which limit single family developments to 
one acre lots and other type developments 
to 12 percent built-upon area will be 
deemed to comply with this requirement. 
.More stringent requirements may be re- 
quired by the Environmental Manage- 
ment Commission in very sensitive areas. 
High Density Option: Higher density de- 
velopments will be allowed if stormwater 
control systems (preferably wet detention 
ponds) are installed, operated and mam- 
tamed which control the runoff from all 
built-upon areas generated from one inch 
of rainfall. The size of the control system 
must take into account the runoff from 
any p>er\'ious surfaces draining to the sys- 
tem. .More stringent requirements may 
be required by the Environmental Man- 
agement Commission in very sensitive ar- 
eas. 
(J) Barnes Creek ( Yadkin Ri\er Basm. In- 
dex No. 13-2- 18) from source to the 
L whame River mcluding all tributary 
waters will have no new discharges of 
waste nor will anv existmg discharges be 
allowed to expand bevond their existing 
permitted wastetlow. 

Statutory Authority G.S. 143-214. 1. 

SECTION .0300 - ASSIGNMENT OF STREAM 
CLASSIFICATIONS 

.0309 YADKIN-PEE DEE Rl\ ER B.4SIN 

(c) The Yadkin-Pee Dee River Basin Schedule 
of Classifications and Water Quality Standards 
was amended effective: 

(1) Februarv 12, 1979; 

(2) .March 1, 1983; 

(3) August 1, 1985; 

(4) February' 1, 1986; 

(5) October 1, 1988; 

(6) March 1, 1989; 
(7] March 1, 1990. 

(fj The Schedule of Classifications and Water 
Quality Standards for the ^'adkm Ri\er Basm 
was amended effective March J_. 1990 as foUows: 
Barnes Creek (Index No. 13-2-18) was reclassi- 
fied from Class C to Class C ORW. 



NORTH C.AROUN.A REGISTER 



431 



PROPOSED RULES 



Statutory Authoritv G.S. 143-214. 1: 143-215. 1: 
l43-2l5.3(ai( I ). 

****************** 



lyotice is hereby given in accordance with G.S. 
I SOB- 1 2 that the Environmental Management 
Commission intends to amend rules cited as 15 
NCAC 2D .0505. .0535. .0902; 2H .0602: and 
adopt rules cited as 15 S'CAC 2D .0946, .1101 - 
.I/OS: 2H .06/0. 

J he proposed effective date of this action is De- 
cember I. 1989. 

1 he public hearing viill be conducted at 1 :00 
p.m. at the following places and dales: 

August 4. 1989 

Ground Floor Hearing Room 

.Archdale Building 

5/2 Sorth Salisbury Street 

Raleigh. AC 

August 9. /989 

Errvironmental Protection Auditorium 

Rankin Health Center 

/200 Blythe Boulevard 

Charlotte. AC 



Co 



ommeni Procedures: .411 persons interested in 
these matters are invited to attend the public 
hearing. Perwns desiring to comment on the 
proposals are requested to give written notice 
thereof on or before the hearing date. Any person 
desiring to present lengthy comments is requested 
to submit a written statement for inclusion in the 
record of proceedings at the public hearing. The 
record of proceedings will remain open for 30 days 
following the hearing to receive additional written 
statements. To be included, the statement must 
be received by the Department within 30 days af- 
ter the hearing date. 

Additional information concerning the hearing or 
the proposals may be obtained by contacting: 
Mr Thomas C. Allen 
Dnision of Environmental M anagement 

P.O. Box 27687 
Raleigh. Sorth Carolina 276I/-7687 

(9/9) 733-3340 

SUBCHAPTER 2D - AIR POLLLTION 
CONTROL REQUIREMENTS 

SECTION .0500 - EMISSION CONTROL 
STANDARDS 



.0505 CONTROL OF EMISSIONS FROM 
INCINERATORS 

(c) Emissions from all incinerators at a plant 
site where the total incinerator capaatv is greater 
than 250 pounds per hour shall not cause anv of 
the foUowmg ambient levels in milligrams per 
cubic meter at 77 degrees Fahrenheit and 29.92 
inches of mercun.- (except for asbestos) to be ex- 
ceeded bevond the premises: 

Annual 
(Carcmogens) 



Lii 
Ql 
Ql 
iil 
151 

16] 

111 

181 

121 

(lOl 

mi 
im 

Oil 

(14) 

nil 

16 



acetaldehvde 
acetic aad 
acrolein 
ammonia 



I'll 



aniline 
arsenic and 
compounds 
asbestos 

aziridine 

benzidine and salts 
benzo(a)pvrene 
benzvl chlonde 
beryllium 
beryllium chloride 
beryllium fluoride 
beryllium mtrate 
bis-chloromethvl 
ether 
bromide 



(19: 
(20; 

[111 
1^ 

1231 
1241 
1251 
(26) 

QZi 



8) cadrmum 

cadmium acetate 
cadmium bromide 
carbon disulfide 
chlorine 
chlorobenzene 



chloroprene 
cresol 

p-dichlorobenzene 
dichJorodi- 



fluoromethane 
(28) dichloroflu- 
oromethane 



29) 



1301 
llll 

[}2l 
1331 

liil 

(35) 

(361 

'^ 

1381 
1121 
(40) 



di(2-ethvlhexvl) 
phthalate 
dimethyl sulfate 
1.4-dioxane 



epichlorohvdrin 
ethvl acetate 
ethvlencdiamine 
ethylene dibromide 
ethylene dichlonde 
ethylene glycol 
monoethvl ether 
ethsl mercaptan 
fluondes 
formaldehyde 



2.3x10' 


2.8x10" 


fibers ml 


1.5xlO-' 


3.3x10-^ 


4.1x10' 


4.1x10" 


4.1x10° 


4.1x10" 


3.7x10" 


5.5x10' 


5.5x10" 


5.5x10" 



8.3x10- 



4.0x10^ 
3.8x10" 



4n 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(41 ) hexachJorocvclo- 

pentadicne 
(42i hcxachJorodibenzo- 

p-diQ'un 

(43) n-hexane 

(44) hexane isomers 
except n-hexane 

(45) hydrazine 

(46) hydrogen chlonde 

(47) hydrogen cyanide 

(48) hydrogen fluoride 

(49) hydrogen sulfide 

(50) maleic anhydnde 



(51 ) manganese and 
compounds 

(52) manganese 
cyclopentadienvl 
tncarbonyj 

(53) manganese tetroxide 

(54) mercury, alkyl 

(55) mercur>', arvl and 



24-hour 



1-hour 



15-mi- 



7.6x10' 



inorganic compounds 
mercury, y apor 



(56) 

(58) methyl ethyl ketone 

(59) 

(60) 

(61) 

(62) 

(632 

(M) 

(65) 



methyl chloroform 



meth\l isobutyl ketone 
methyl mercaptan 
mckel dust 
nickel subsutflde 
nitnc acid 
nitrobenzene 



N-iiitros(^di- 
methxiamine 



3.3x10- 
2.1x10' 



5.0x10 = 



(66) 

(68) 
(69) 
(70) 

llli 
[731 

IZil" 

(75) ■ 



pcntjchlorophenol 

phcn'.'j 

phosgene 

phosphme 

poKchlonnated 
biphenyls 

stsrcne 

sultunc acid 

1.1. 1.2-tetrachloro- 
2.2-ditluoroethane 

1.1.2.2-tetrachloro- 

.2-difluoroethane 

1 .1.1.2-tclrachloro- 



8.3x10' 



(76) 
(77) 


ethane 

toluene 

toluene- 
2.4-dii50cyanate 


(78) 


tnchlorofluoro- 


(79) 


methane 
1.1.2-tnchloro- 




1 ,2.2-tnfluoroethane 


(80) 
(SI) 


\in\l chlonde 
yinshdene chlonde 



6.3xl0- 



3.8x10-' 



(S2i xylene 









nute 




(Chronic 


(Acute 


( .Acute 




Toxicants) 


Systemic 
Toxicants) 


Imtants) 


01 






27 


til 






3.7 


lil 






0.08 


til 






2.7 


Qi 




1 




(61 








IZi 








(Hj 


0.006 






121 








(10) 








(11) 




0.5 




(12) 








(13) 








(14) 








(13) 








(16) 








(17) 






0.2 


(18) 








(19) 








(20) 








(21) 


"-6 






(22) 


' ^75 




0.9 


(24i 


—-7 


3.5 




(25. 




2.2 




(26) 






66 


(27): 


u^ 






(28) 


u,.~> 






(29) 


0.03 






(30) 


0.003 






(31) 


0.56 






(32) 








[ii] 




140 




(34) 


0.3 


2.5 




(33) 








(36) 








(37) 


0.12 


1.9 




(38) 




0.1 




(39) 


0.016 


0.25 




(40) 






0.15 


(41) 


0.0006 


0.01 




(42) 








(43) 


1.1 






(44) 






360 


(45) 


0,0006 






(46) 






0.7 


(47) 


0.14 


1.1 




(48) 


0.03 




0.25 


(49) 






2.1 


(50) 


0.012 


0.1 




(51) 


0.031 






(32) 


0.0006 






(53) 


00062 







NORTH CAROLINA REGISTER 



433 



PROPOSED RULES 



(54) 


0.00006 






(55f 


0.0006 






(56) 


0.0006 






(57) 


12 




245 


(58, 


3.7 




88.5 


(59) 


2.56 


30 




(60, 




0.05 




(61) 








(62) 








(6J, 






1 


(64) 


0.06 


0.5 




(65) 








(66) 


0.003 


0.025 




(67) 


0.95 






(68) 


0.0025 






(69) 






0.13 


(70, 








(71) 


1.34 




42.5 


(72) 


0.012 


0,1 




(73, 


52 






(74) 


52 






( '>) 








(76) 


4.7 




56 


(77) 


0.0005 




0.01 


(78, 




560 




(79, 






950 


(80) 








(81) 


0.12 






(82) 


2.7 




65 



3.0x10' 
5'9xT0^ 
(e) Ambient air concentrations shall be deter- 



p-dioxin 
'""' tnchJoroethvlene 



(d) After December _K 1990. emissions from aU 
incinerators at a plant site where the total incm- 
erator capacit\ is greater than 250 pounds per 
hour shall not cause anv of the following ambient 
le\'els in milligrams per cubic meter at Tl_ degrees 
Fahrenheit and 2*^.92 inches of mercury to be 
exceeded bevond the premises: 

Annual 

(Carcinogens) 

1.5x10^ 

8.3x10* 



lii 

121 

Ql 
IS) 
12i 

(10) 

(11) 

(12) 
(14) 

(Ifo) 

(18) 
(19) 
(20) 



acr%lonitrile 
ammomum chromate 
ammonium dichromate 
benzene 
1.3-butadiene 



calcium chromate 
carbon tetrachloride 
chloroform 
chromic acid 
chromium (VI) 
ethylene oxide 
hthium chromate 
methvlene chlonde 



£C 



rchloroethvlene 



potassium chromate 
potassium dichromate 
sodium chromate 
sodium dichromate 



strontium chromate 
tetrachlorodibenzo- 



8.3x1 (F 
1.2x10" 
1.7x10" 
8.3x10' 
6,7x10-^ 
4.3x10-^ 
8.3x10' 
8.3x10' 
2.7x10' 
8.3x10' 
2.4x10^ 
1.9x10' 
8.3x10' 
8.3x10' 
8.3x10' 
8.3x10' 
8.3x10' 



mined by usmg appropnate Environmental Pro- 
tection Agency dispersion modeling procedures 
or other methods specified by the director. Am- 
bient air concentrations are to be evaluated for 
annual period over a calendar year, for 24-hour 
periods from midmght to midnight, for one-hour 
penods begmrung on the hour, and for 1 5-rmnute 
penods beginnmg on the hour or ]_5^ 30, or 45 
rrunutes after the hour. The identification of 
each toxic air poUutant emitted and its corre- 
sponding emission rate shall be determined usmg 
mass balancing analysis, source testing, or other 
methods acceptable to the director. 

(D For mcmerators at a plant site where the 
total incinerator capacity is greater than 250 
pounds per hour, the emissions of: 

( 1) hydrogen chloride shall not exceed four 
pounds per hour unless the emission is 
reduced by at least 99 percent by weight 
and: 

(2) mercury shall not exceed seven pounds per 
24-hour period. 

(g) Any incmerator owned by one person used 
to bum waste generated bv another person shaU 
meet the requirements of Paragraph (c|, (d), and 
(f} of this Rule mcluding incinerators at plant 
sites with an mcmerator capacity of 250 pounds 
per hour or less. 

(h) The ouner or ot>erator of an incinerator 
subiect to Paragraph (£| or (f[ of this Rule that: 

( 1) began construction after November 30. 
1989, shall be in comphance with Para- 
graph (c) and (f} of this Rule before be- 
gmnmg operation. 

(2) began construction before December _!_, 
1989, shall adhere to the following incre- 
ments of progress and schedules: 

(A) Documentation that the incinerator 
meets the requirements of Paragraphs (c) 
and (1} of this Rule or an air permit ap- 
plication mcluding fmal plans and a com- 
pliance schedule shall be subrmtted 
before: 

(i| June ]_, 1990, for incinerators at plant 
sites with an incmerator capacity of 800 
pounds per hour or more; 
(u) December 1, 1990, for mcmerators at 
plant sites with an mcmerator capacity 
of less than 800 pounds per hour but 
600 pounds per hour or more: 
(ill) June 1, 1991. for mcmerators at plant 
sites with an mcmerator capaaty of less 
than 600 pounds per hour but 400 
pounds per hour or more; 



434 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(iv) December jj 1991, for plant sites 
with an incinerator capaatv of less than 
400 pounds per hour. 

(B) The compliance schedule shall contain 
the following mcrements of progress: 

[ij a date by which contracts for the 
emission control system and or process 
equipment shall be awarded or orders 
shall be issued for purchase of compo- 
nent parts; 

(ii) a date by which on-site construction 
or installation of the emission control 
and'or process equipment shall begin; 

(iii) a date by which on-site construction 
or installation of the ermssion control 
and or process equipment shall be 
completed; and 

(iv) a date by which final compliance 
shall be achieved. 

(C) The final compliance date under Para- 
graph (h)(2)(B)(iv) of this Rule shall not 
be later than: 

[i] June 1, 1992, for incinerators at plant 
sites with an incinerator capaaty of 800 
pounds per hour or more; 

(ii) December \j_ 1992. for incmerators at 
plant sites with an incinerator capaaty 
of less than 800 pounds per hour but 
600 pounds per hour or more; 

(iii) June 1, 1993, for mcinerators at plant 
sites with an innnerator capacity of less 
than 600 pounds per hour but 400 
pounds per hour or more; 

(iv) December J_. 1993, for mcinerators 
at plant sites with an incinerator capac- 
ity of less than 400 pounds per hour. 

The owner or operator shall certify to the 

director pnor to the date five davs after 

the deadline for each increment of pro- 



gress whether the required mcrement of 
progress has been met, 
(i) The owner or operator of an incinerator 
subject to Paragraph (d) of this Rule that: 
( 1 1 began construction after November 30, 
1990, shall be in compUance with Para- 
graph (d) before beginning operation. 
(2) began construction before December _1^ 
1^90, shall adhere to the foUowmg mcre- 
ments of progress and schedules: 
(A) Documentation that the mcinerator 
meets the requirements of Paragraphs (d) 
of this Rule or an air permit application 
includmg final plans and a compliance 
schedule shall be submitted before: 
(VI June 1. 1991, for mcmerators at plant 
sites with an inonerator capacity of 800 
pounds per hour or more; 



(ii) December 1 , 1 99 1 , for incmerators at 
plant sites with an inonerator capaaty 
of less than 800 pounds per hour but 
600 pounds per hour or more; 

(iii) June 1, 1992, for mcinerators at plant 
sites with an incinerator capacity of less 
than 600 pounds per hour but 400 
pounds per hour or more; 

(iv) December L 1992, for plant sites 
with an incinerator capacity of less than 
400 pounds per hour. 

(B) The compliance schedule shall contain 
the following increments of progress: 

(i) a date by which contracts for the 
emission control system and/or process 
equipment shall be awarded or orders 
shall be issued for purchase of compo- 
nent parts; 

(ii) a date by which on-site construction 
or installation of the emission control 
and or process equipment shall begm; 

(iii) a date by which on-site construction 
or installation of the emission control 
and or process equipment shall be 
completed; and 

(iv) a date bv which final compliance 
shall be achieved. 

(C) The fmal compbance date under Para- 
graph (i)(2)(B)(iv) of this Rule shall not 
be later than: 

(i] June 1. 1993. for incinerators at plant 
sites with an incinerator capaaty of 800 
pounds per hour or more; 

(ii) December 1, 1993, for mcinerators at 
plant sites with an incinerator capaaty 
of less than 800 pounds per hour but 
600 pounds per hour or more; 

(iii) June 1, 1994, for incinerators at plant 
sites with an mcmerator capacity of less 
than 600 pounds per hour but 400 
pounds per hour or more; 

(iv) December j_^ 1994, for incinerators 
at plant sites with an mcinerator capac- 
ity of less than 400 pounds per hour. 

The owner or operator shall certify to the 

director prior to the date five davs after 

the deadlme for each mcrement of pro- 



gress whether the requu-ed mcrement of 

progress has been met, 
(i) When Paragraphs (c) or (d ) of this Rule and 
Rule .0524 or .0525 of this Subchapter regulate 
the same pollutant, the more restrictive regu- 
lation shall apply, notwithstanding provisions of 
Rules .0524 or .0525 of this Subchapter to the 
contrary. 

Statutory Authority G.S. 142-215.3(a)(l ): 143- 
215.107(a)(5). 



NORTH CAROLINA REGISTER 



435 



PROPOSED RULES 



.0535 MALFLNCTION: START-LP AND 
SHLT-DOWN 

(a) For the purpose of this Regulation the fol- 
lowing definitions apply: 

(1) "Excess Emissions" means an emission 
rate that exceeds any applicable emission 
limitation or standard allowed by any re- 
gulation m Sections .0500 or .0900 of this 
Subchapter or by a p>ermit condition or 
that exceeds an emission limit estabbshed 
in a permit issued under 15 NCAC 2H 

.o6ro. 

(b) This Regulation does not apply to sources 
to which Regulation .0524 or .0525 of this Sec- 
tion applies ef l» whioh 40 CFR Part 6© ef 64- 
appli g o. unless excess emissions exceed an emis- 
sion limit established in a permit issued under 15 
NCAC 2H .0610 that is " more strmgent than the 
emission limit set by Rules .0524 or .0525 of this 
Section. • 

(d) .All electric utility boiler units subject to a 
regulation in this Section shall have a malfunc- 
tion abatement plan approved by the director. 
In addition, the director may require any other 
source tfeat b» has dotonTun «4 te hav« ha4 » fe**- 
tepv »f oKCQoo omiooiono to have a malfunction 
abatement plan approved by the director. TTie 
malfunction plans of electric utility boUer units 
and of other sources required to have them shall 
be implemented when a malfunction or other 
breakdown occurs. The purpose of the mal- 
function abatement plan is to prevent, detect, and 
correct malfunctions or equipment failures that 
could result m excess emissions. A malfunction 
abatement plan shall contain as a minimum: 

Statutory Authority G.S. l43-2l53(a)( I ); 143- 
215.107(a)(4): 143-215. 107(a)(5). 

SECTION .0900 - VOLATILE ORGANIC 
COMPOLNDS 

.0902 APPLICABILITY 

(b) This Section does not apply to: 

(2) sources at a facility where the total of 
potential emissions of volatile organic 
compounds from all stationary sources at 
the facility is He* moro less than 100 tons 
per year (This Subparagraph does not ap- 
ply to the manufacture and use of cutback 
asphalt or to Rules .0925, .0926. .0927. 
.0928. .0932, and .0933 of this Section. ); 

(3) facilities located m an area which is not 
designated by the U.S. Environmental 
Protection Agency to be a nonattainment 
area for photochemical oxidants or ozone 
as of April 30, 1979 (This Subparagraph 
does not apply to Rules .0925, ,0926. 



.0927, .0928, .0932, and .0933 of this Sec- 
tion.); 

Statutory Authority G.S. I43-2l5.3(a)( I ); 143- 
215.107(a)(5). , 

.0946 COMPLIANCE SCHEDLLE: GASOLINE 
H.ANDLING 

(a) With the exception in Paragraph (b) of this 
Rule, this Rule applies to all sources covered by 
Rules .0925, .0926, .0927, .0928, .0932, or .0933 
of this Section. 

(b) This Rule does not apply to sources in 
Mecklenburg County to which Rules .0925, 
.0926, .0927, .0928, .0932, or .0933 of this Section 
apply and which are located at a facility where 
the total potential emissions of volatile organic 
compounds from all stationary sources at the fa- 
cility are 100 tons f)er year or more. 

(c) The owner or operator of any bulk gasoline 
plant or bulk gasoline terminal subject to this 
Rule and Rule .0926 or .0927 of this Section or 
any tank subject to this Rule and Rule .0925 or 
.0933 of this Section and located at a bulk gaso- 
line plant or bulk gasoline terminal subject to this 
Rule and Rule .0926 or .0927 of this Section shall 
adhere to the following increments of progress 
and schedules: 

(1) The air permit application includmg fmal 
plans and a compliance schedule shall be 
submitted before June 1, 1990; 

(2) The compliance schedule shall contain the 
following increments of progress: 

(A) a date by which contracts for the emis- 
sion control system and/or process equip- 
ment shall be awarded or orders shall be 
issued for purchase of component parts; 

(B) a date by which on-site construction 
or installation of the emission control 
and/or process equipment shall begin; 

(C) a date by which on-site construction 
or installation of the emission control 
and/or process equipment shall be com- 
pleted; and 

(3) Final compliance shall be achieved by 
December 1, 1990. 

The owner or operator shall certify to the direc- 
tor pnor to the date five days after the deadline 
for each increment whether the required incre- 
ment of progress has been met. 

(d) The owner or operator of any gasoline ser- 
vice station or gasoline dispensmg facility subject 
to this Rule and Rule .0928 of this Section shall 
comply with Rules .0928, .0932, .0925, and .0933 
of this Section by December 1, 1990. 

Statutory Authority G.S. 143-215.3(aj( I ); 143- 
215.107(a)(5). 



436 



yORTH CAROLINA REGISTER 



PROPOSED RULES 



fibers /ml 



SECTION .1 100 - CONTROL OF TOXIC AIR 
POLLLTANTS 

.1101 PLRPOSE 

This Section sets forth the mles for the control 
of toxic air pollutants to protect human health. 

Statutory Authority G.S. l43-215.3(a)( I ); /43- 
215.107(a)(1). (3), (4). (5); I43B-282. 

.1102 APPLICABILITY 

(a) The toxic air poUutant rules in this Section 
apply to all facilities that emit a toxic air pollu- 
tant that are required to have permit under 15 
NCAC 2H .0610. 

(b) VVTien a rule in Section .0500 or .0900 of 
this Subchapter and this Section regulates the 
same pollutant, the more restrictive rule shaO 
apply. 



Statutory Authority G.S. l43-2I5.3(a)( I ); 
215.107(a)(1), (3). (4), (5); I43B-282. 



143- 



.1103 DEFINITION 

For the purpose of this Section, the following 
definitions apply: 

(1) "Toxic air pollutant" means any of those 
carcinogens, chronic toxicants, acute sys- 
temic toxicants, or acute irritants that are 
listed in Rule .1104 of this Section. 

(2) "Asbestos" means asbestos fibers as defmed 
in 40 CFR 61.141. 



Statutory Aulhoritv 

l43-2I5.3(a)(l): 143B-282. 



G.S. 



143-213; 



.1104 TOXIC AIR POLLUTANT GUIDELINES 

(a) A facility shall not emit any of the followmg 
toxic air poUutants in such quantities that may 
cause or contribute beyond the premises (contig- 
uous property boundary) to any significant am- 
bient air concentration that may adversely affect 
human health. In determining these significant 
ambient air concentrations, the division shall be 
guided by the following list of acceptable ambient 
levels in milligrams per cubic meter at 77° F (25° 
C) and 29.92 inches (760 mm) of mercury pres- 
sure (except for asbestos): 

Annual 
(Carcinogens) 



(1) 
(2) 
(3) 
(4) 
(5) 
(6) 

(7) 



acetaldchyde 
acetic acid 
acrolein 
ammonia 
aniUne 
arsenic and 
compounds 
asbestos 



2.3x10-' 
2.8x10" 



(8) aziridine 




(9) benzidme and salts 


1.5x10' 


(10) benzo(a)pyrene 


3.3x10-' 


(11) benzyl chloride 




(12) beryllium 


4.1x10-' 


(13) beryllium chloride 


4.1x10-' 


(14) beryllium fluoride 


4.1x10"' 


( 1 5) beryllium nitrate 


4.1x10-* 


(16) bis-chlororaethyl 




ether 


3.7X10-'' 


( 1 7) bromide 




( 1 8) cadmium 


5.5x10-' 


( 1 9) cadmium acetate 


5.5x10-* 


(20) cadmium bromide 


5.5x10^ 


(21) carbon disulfide 




(22) chlorine 




(23) chlorobenzene 




(24) chloroprene 




(25) cresol 




(26) p-dichlorobenzene 




(27) dichlorodi- 




fluoromethane 




(28) dichloroflu- 




oromethane 




(29) di(2-ethylhexyl) 




phthalate 




(30) dimethyl sulfate 




(31) 1,4-dioxane 




(32) epichlorohydrin 


8.3x10-' 


(33) ethyl acetate 




(34) ethylenediamine 




(35) ethylene dibromide 


4.0x10^ 


(36) ethylene dichloride 


3.8x10-' 


(37) ethylene glycol 




monoethyl ether 




(38) ethyl mercaptan 




(39) fluondes 




(40) formaldehyde 




(41) hexachlorocyclo- 




pentadiene 




(42) hexachlorodibenzo- 




p-dioxin 


7.6x10-' 


(43) n-hexane 




(44) hexane isomers 




except n-hexane 




(45) hvdra7ine 




(46) hydrogen chloride 




(47) hydrogen cyanide 




(48) hydrogen fluoride 




(49) hydrogen sulfide 




(50) maleic anhydride 




(51) manganese and 




compounds 




(52) manganese 




cyclopentadienyl 




tricar bonyl 




(53) manganese tetroxide 





NORTH CAROLINA REGISTER 



437 



PROPOSED RULES 



(54) mercury, alkyl 






(15-) 








(55) mercury, ar>l and 






(16) 








morgamc compounds 






(17) 






0.2 


(56) mercuPr', vapor 






(18) 








(57) methyl chloroform 






(19) 








(58) methyl ethyl ketone 




' 


(20) 








(59) methyl isobutyl ketone 






(21) 


0.186 






(60) methyl mercaptan 






(22) 


0.0375 




0.9 


(61) nickel dust 


3.3x10-' 




(23) 


2.2 






(62) mckel subsulfide 


2.1x10' 




(24) 


0.44 


3.5 




(63) nitnc acid 






(25) 




2.2 




(64) mtrobenzene 






(26) 






66 


(65) N-mtrosodi- 






(27) 247 






methylamine 


5.0x10' 




(28) 


0.5 






(66) pentachJorophenol 






(29) 


0.03 






(67) phenol 






(30) 


0.003 






(68) phosgene 






(31) 


0.56 






(69) phosphme 






(32) 








(70) polychlonnated 






(33) 




140 




biphenyls 


8.3x10' 




(34) 


0.3 


2.5 




(71) styrene 






(35) 








(72) sulfuric acid 






(36) 








(73) 1,1,1,2-tetrachloro- 






(37) 


0.12 


1.9 




2,2-difluoroethane 






(38) 




0.1 




(74) 1.1,2,2-tetrachloro- 






(39) 


0.016 


0.25 




1,2-difluoroethane 






(40) 






0.15 


(75) 1.1,1,2-tetrachloro- 






(41) 


0.0006 


0.01 




ethane 


6.3x10-^ 




(42) 








(76) toluene 






(43) 


1.1 






(77) toluene- 






(44) 






360 


2,4-dusocyanate 






(45) 


0.0006 






(78) trichJorofluoro- 






(46) 






0.7 


methane 






(47) 


0.14 


1.1 




(79) 1,1,2-tnchloro- 






(48) 


0.03 




0.25 


1 ,2,2-tnfluoroethane 






(49) 






2.1 


(80) vinyl chJonde 


3.8x10^ 




(50) 


0.012 


0.1 




(81) vinvlidene chloride 






(51) 


0.031 






(82) xylene 






(52) 
(53) 


0.0006 
0.0062 






24-hour 1-hour 


15- 


mi- 


(54) 


0.00006 








nute 


(55) 


0.0006 






(Chrome (Acute 


(Acute 


(56) 


0.0006 






Toxicants) Systemic 


Imtants) 


(57) 


12 




245 


Toxicant 


s) 




(58) 


3.7 




88.5 


(1) 




27 


(59) 


2.56 


30 




(2) 




3.7 


(60) 




0.05 




(3) 




0.08 


(61) 








(4) 




2.7 


(62) 








(5) ' 1 






(63) 






1 


(6) 






(64) 


0.06 


0.5 




(7) 






(65) 








(8) 0.006 






(66) 


0.003 


0.025 




(9) 






(67) 


0.95 






(10) 






(68) 


0.0025 






(11) 0.5 






(69) 




0.13 




(12) 






(70) 








(13) 






(71) 


1.34 




42.5 


(14) 






(72) 


0.012 


0.1 





4i8 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(73) 


52 


(74) 


52 


(75) 




(76) 


4.7 


(77) 


0.0005 


(78) 




(79) 




(80) 




(81) 


0.12 


(82) 


2.7 



560 



56 
0.015 

950 



65 
(b) A facility shall not emit after December 1, 
1990, any of the following toxic air pollutants in 
such quantities that may cause or contribute be- 
yond the premises to any significant ambient air 
concentration that may adversely affect human 
health. In determining these significant ambient 
air concentrations, the division shall be guided 
by the following list of acceptable ambient levels 
in milligrams per cubic meter at 77° F (25° C) 
and 29.92 inches (760 mm) of mercury pressure: 

Annual 



(1) 


acrylonitrile 


(Carcinogens) 
1.5x10^ 


(2) 


ammomum chromate 


8.3x10-* 


(3) 


ammomum dichromate 


8.3x10* 


(4) 


benzene 


1.2x10"' 


(5) 


1,3-butadiene 


1.7x10^ 


(6) 


calcium chromate 


8.3x10* 


(7) 


carbon tetrachloride 


6.7x10' 


(8) 


chloroform 


4.3x10-' 


(9) 


chromic acid 


8.3x10* 


(10) 
(H) 


chromium (VI) 
ethylene oxide 


8.3x10* 
2.7x10' 


(12) 


lithium chromate 


8.3x10* 


(13) 


methylene chlonde 


2.4x10-' 


(14) 
(15) 


perchloroethylene 
potassium chromate 


1.9x10' 
8.3x10* 


(16) 

(17) 


potassium dichromate 
sodium chromate 


8.3x10* 
8.3x10* 


(18) 


sodium dichromate 


8.3x10* 


(19) 


strontium chromate 


8.3x10* 


(20) 


tetrachlorodibenzo- 






p-dioxin 


3.0x10-' 


(21) 


tnchloroethvlene 


5.9x10-' 



Statutory Authority G.S. l43-2IS.3(a)(l ); 143- 
215.107(a)(3). (4), (5); I43B-282. 

.1105 FACILITY REPORTING: 
RECORDKEEPING 

(a) The owner or operator of a facility emitting 
a toxic ajr pollutant shall maintain records de- 
tailing all activities related to any compliance 
schedule. 

(b) The owner or operator of a facility emitting 
a toxic air pollutant shall maintain, m wntmg, 
data and or reports relatmg to momtonng in- 
struments or procedures that wUl, up>on review, 



assist in documenting the compliance status of 
the facility or control equipment to the satisfac- 
tion of the commission. 

(c) Copies of all records and reports under 
Paragraphs (a) and (b) of this Rule shall be re- 
tained by the owner or operator for a period of 
two years after the date on which the record was 
made or the report submitted, except that the 
director may extend the retention period in par- 
ticular instances. 

(d) Copies of all records and reports under this 
Section shall be made available to the director 
upon request. 

(e) The reporting and recordkeeping require- 
ments of this Section shall be specified in the 
permit issued pursuant to 15 NCAC 2H .0610. 

Statutory Authority G.S. l43-215.3(a)( I ); 143- 
215.68; 143-215. 107(a)(4), (5): 143B-282. 

.1 106 DETERMINATION OF AMBIENT AIR 
CONCENTRATIONS 

Ambient air concentrations shall be determined 
by using appropriate Environmental Protection 
Agency dispersion modeling procedures or other 
methods specified by the director. Ambient air 
concentrations are to be midnight to midnight, 
for one-hour periods beginning on the hour, and 
for 15-nunute periods beginning on the hour or 
15, 30, or 45 rmnutes after the hour. The iden- 
tification of each toxic air p>oUutant emitted and 
its corresponding emission rate shaU be deter- 
mined using mass balancing analysis, source 
testing, or other methods acceptable to the di- 
rector. 

Statutory Authority G.S. 143-215.3(a)( 1 ); 143- 
215.107(a)(3). (5); 143B-2S2. 

.1107 MLLTIPLE FACILITIES 

(a) If an acceptable ambient level in Rule .1 104 
of this Section is exceeded because of emissions 
of two or more facilities and if public exposure 
is such that the commission believes that human 
health may be adversely affected, then the com- 
mission may require the subject facilities to apply 
additional controls or to otherwise reduce emis- 
sions. 

(b) The allocation of the additional reductions 
shall be based on the relative contributions to the 
poUutant concentrations unless the owners or 
operators agree otherwise. 

(c) The owner or operator of a facility shall not 
be required to conduct the multi-facility ambient 
impact analysis described in Paragraph (a) of this 
Rule. This type of analysis shall be done by the 
Division of Environmental Management. 



NORTH CAROLINA REGISTER 



439 



PROPOSED RULES 



Statutory Authority G.S. l43-2l5.3(a)( I ): 143- 
215.107(a)(3), (5): I43B-282. 

.1108 MULTIPLE POLLLTANTS 

(a) If a facility or combination of facilities emits 
two or more toxic air pollutants which act in the 
same way to affect human health so that their 
effects may be additive or enhanced and if public 
exposure is such that the commission believes 
that human health may be adversely affected, 
then the commission may require the subject fa- 
cility or facilities to apply additional controls or 
to otherwise reduce emissions. 

(b) The allocation of the additional reductions 
shall be based on the relative contributions to the 
pollutant effect unless the owners or operators 
agree otherwise. 

(c) The owner or operator of a facility shall not 
be required to conduct the multi-facility or mul- 
ti-pollutant analysis described in Paragraph (a) 
of this Rule. This type of analysis shall be done 
by the Division of Envu-onmental Management. 

Statutory Authority G.S. 143-21 5.3(a)( I ): 143- 
2l5.l07'{a)(3). (5); I43B-282. 



SLBCHAPTER 2H - PROCEDURES FOR 
PERMITS: APPROVALS 

SECTION .0600 - AIR QUALITY PERMITS 

.0602 DEFINITIONS 

Unless the context otherwise requires, the terms 
used in this Section shall be used as defmed in 
G.S. 143-213 and as follows: 
(6) "Maximum feasible control" means the 
maximum degree of reduction for each pol- 
lutant subiect to regulation in this Section 
usmg the best technology that is available 
taking mto account, on a case-bv-case basis, 
enerB\', environmental, and economic im- 



pacts and other costs. 

Statutory Authority 

l43-2l5.3(ai(n. 



G.S. 



143-213: 



.0610 PERMIT REQUIREMENTS FOR TOXIC 
AIR POLLUTANTS 

(a) No person shall cause or allow any toxic 
air pollutant named m 1 5 NC AC 2D . 1 1 04 to be 
emitted into the atmosphere from any source 
without having received a permit from the com- 
mission in accordance with the following: 

(1) Sources and modifications of sources 
which require a permit or permit modifi- 
cation because of the applicability of Sec- 
tions m Subchapter 2D of this Chapter 
other than Section .1 100 and which begm 



construction after November 30, 1989, 
shall have received a permit or permit 
modification to emit toxic air pollutants 
before beginning construction and shall 
be in compliance with their permit when 
beginnmg operations. 

(2) Paragraph (a)(1) of this Rule does not 
apply to sources whose emissions result 
from only combusting unadulterated fossil 
fuels or unadulterated wood. 

(3) The owner or operator of any other source 
shall have 180 days to apply for a permit 
or permit modification for the emissions 
of toxic air pollutants after receiving writ- 
ten notification from the division. 

(4) When the director calls for permit appli- 
cations for facilities pursuant to Paragraph 
(a)(3) of this Rule, he shall call for f)emiit 
applications on the basis of standard in- 
dustrial classifications, that is, he shall call 
at one time for permits for all facilities 
statewide that have the same four-digit 
standard industrial classification code, ex- 
cept those facilities located in certified lo- 
cal air pollution control agency areas. All 
members of a source or facility category 
not having a standard industrial classifica- 
tion code shall similarly be called at one 
time. 

(5) The owner or operator of a source re- 
quired to obtain a permit or permit mod- 
ification before the date on which the 
guidelmes m 15 NCAC 2D .1104(b) be- 
come effective shall be required to obtain 
the permit or p>ermit modification only for 
toxic air poOutants named in 15 NCAC 
2D .1 104(a). However, the owner or op- 
erator of the source will later be required 
in accordance with Paragraph (a)(3) of 
this Rule to obtain permit modifications 
covering toxic air pollutants named in 15 
NCAC 2D .1104(b). 

(b) TTie owner or of)erator of a source who is 
applying for a permit or permit modification to 
emit toxic air pollutants shall: 

(1) demonstrate to the satisfaction of the 
commission through dispersion modeling 
that the emissions of toxic air pollutants 
from the facility will not cause any ac- 
ceptable ambient level listed in 15 NCAC 
2D .1 104 to be exceeded; or 

(2) demonstrate to the satisfaction of the 
commission that the ambient concen- 
tration beyond the premises (contiguous 
prof)erty boundary) for the subject toxic 
air poUutant will not adversely affect hu- 
man health even though the concentration 



440 



NORTH CAROLINA REGISTER 



, 



PROPOSED RULES 



is higher than the acceptable ambient level 
in 15 NCAC 2D .1104, 

(c) The owner or operator of any source con- 
structed before December 1, 1989, who cannot 
supply a demonstration described in Paragraph 
(b) of this Rule shall: 

(1) submit a compliance schedule acceptable 
to the commission that will reduce the 
subject toxic aix pollutant ambient con- 
centration to a level that will not exceed 
any acceptable ambient level listed in 15 
NCAC 2D. 11 04; 

(2) demonstrate to the satisfaction of the 
commission that complying with the 
guideUnes m 15 NCAC 2D .1104 is tech- 
nically infeasible; or 

(3) demonstrate to the satisfaction of the 
commission that complying with the 
guidelines m 15 NCAC 2D .1104 would 
result in significant economic hardship. 

(d) If the owner or operator makes a demon- 
stration to the satisfaction of the commission 
pursuant to Paragraph (c)(2) or (3) of this Rule, 
the commission shall require the owner or of)er- 
ator of the source to apply maximum feasible 
control. 

(e) If the owner or operator of a source chooses 
to make a demonstration pursuant to Paragraph 
(b)(2) or (c)(2) or (3) of this Rule, the commis- 
sion shall approve or disapprove the permit after 
a public heanng The public hearing shall meet 
the requirements of Paragraph (e) of Rule .0603 
of this Section except that the p>ermit, if ap- 
proved, shall not become part of the North Ca- 
rolina State Implementation Plan for Air Quality. 

(f) If the owner or operator of a facility dem- 
onstrates by modeling that any toxic air pollutant 
emitted from his facility contributes an incre- 
mental concentration to the ambient air concen- 
tration of that pollutant beyond his premises 
which is less than the acceptable ambient level 
values given in 15 NCAC 2D .1104, he does not 
have to provide any further modelmg demon- 
stration with his permit application. However, 
the commission may still require more stringent 
emission levels in accordance with its analysis 
under 15 NCAC 2D .1107 or .1108. 

(g) A permit to emit toxic air pollutants shall 
not be required for: 

(1) the noncommercial use of household 
cleaners, household chemicals, or house- 
hold fuels in private residences; 

(2) asbestos demohtion and renovation pro- 
jects that comply with 15 NCAC 2D 
.0525 and that are being done by persons 
accredited by the Department of Human 
Resources under the Asbestos Hazard 
Emergency Response Act, 



(3) 



(4) 



(5) 



(6) 



emissions from gasoline dispensing facility 
or gasoline service station operations per- 
formed as a part of petroleum distribution 
to the ultimate consumer where the emis- 
sions comply with 15 NCAC 2D .0524, 
.0925, .0928, .0932 and .0933 and that re- 
ceive gasoline from bulk gasoline plants 
or bulk gasoline terminals that complv 
with 15 NCAC 2D .0524, .0925, .0926, 
.0927, .0932, and .0933 via tank trucks 
that comply with 15 NCAC 2D .0932; 
the use for agricultural operations by a 
fanner of fertilizers, pesticides, or other 
agricultural chemicals containing one or 
more of the compounds listed in 15 
NCAC 2D .1104 if such compounds are 
applied m accordance with label in- 
structions, agronomic practices acceptable 
to the North Carolina Department of 
Agriculture and the commission, or when 
applicable in accordance with regulations 
of the North Carolina Pesticide Board, 
emissions of phosphine resulting from the 
fumigation of agricultural product proc- 
essing, storage, or transportation equip- 
ment or structures before December 1, 
1990; 

any facility whose actual emissions from 
all sources are no more than the follow- 
ing: 

Ib/yr 



(A) acetaldehyde 




(B) acetic acid 




(C) acrolein 




( D) acrylomtrile 


10 


(E) ammonia 




(F) ammomum chromate 


0.0056 


(G) ammonium dichromate 


0.0056 


(H) aniline 




(1) arsenic and 




comfjounds 


0.016 


(J) asbestos 


1.9x10' 


(K) aziridine 




(L) benzene 


8.1 


(M) benzidine and salts 


0.0010 


(N) benzo(a)pyrene 


2 2 


(O) benzyl chloride 




(P) beryllium 


0.28 


(Q) beryllium chloride 


0.28 


(R) beryllium fluoride 


0.28 


(S) beryllium nitrate 


0.28 


(T) bis-chloromethyl 




ether 


0.025 


( U) bromine 




(V) 1,3-butadiene 


12 


(W) cadmium 


0.37 


(X) cadmium acetate 


0.37 


(Y) cadmium bromide 


0.37 



NORTH CAROLINA REGISTER 



441 



PROPOSED RULES 



(Z) calcium chromate 


0.0056 


(UUU) 


methyl mercaptan 




(\A) carbon disulfide 




(VWW) mckeldust 


2.2 


(BB) carbon tetrachloride 


46 


(WWW) 


nickel subsulfide 


0.14 


(CC) chlorine 




(XXX) I 


iitric acid 




(DD) chloro benzene 




(YYY) mtrobenzene 




(EE) chloroform 


290 


(ZZZ) N-nitrosodi- 




(FF) chloroprene 




methylamine 


3.4 


(GG) chromic and 


0.0056 


(AAAA) 


pentachlorophenol 




(HH) chromium (VI) 


0.0056 


(BBBB) 


perchloroethylene 13,000 


(II) cresol 




(CCCC) 


phenol 




(JJ) p-dichlorobenzene 




(DDDD) 


phosgene 




(KK) dichlorodi- 




(FEEE) 


phosphme 




fluoromethane 




(FEEF) 


polychlorinated 




(LL) dichloroflu- 




biphenyls 


5.6 


oromethane 




(GGGG) 


potassium chromate 


0.0056 


(MM) di(2-ethylhexyl) 




(HHHH) 


potassium dichromate 0.0056 


phthalate 




(IIII) sodium chromate 


0.0056 


(NN) dimethvl sulfate 




(JJJJ) sodium dichromate 


0.0056 


(00) 1,4-dioxane 




(KKKK) 


strontium chromate 


0.0056 


(PP) epichlorohydnn 


5600 


(LLLL) 


styrene 




(QQ) ethyl acetate 




(MMMM) sulfuric acid 




(RR) ethylenediamme 




(NNNN) 


tetrachJorodi- 




(SS) ethylene dibromide 


27 


benzo-p-dioxin 


0.00020 


(11) ethylene dichlonde 


260 


(0000) 


1,1,1,2-tetrachJoro- 




(UU) ethylene glycol 




2,: 


Ndifluoroethane 




monoethyl ether 




(pppp) 


1.1.2.2-tetrachloro- 




(V"^) ethylene oxide 


1.8 


1 ,2-difluoroethane 




(\VW) • ethvl mercaptan 




(0000) 


1 , 1 , 1 ,2-tetrachloro- 




(XX) fluorides 




ethane 


430 


(W) formaldehyde 




(RRRR) 


toluene 




(ZZ) hexachlorocyclo- 




(SSSS) toluene- 




pentadiene 






-diisocyanate 
tnchloro- 




(.AAA) hexachlorodibenzo- 


(HID 




p-dioxm 


0.0051 


ethylene 


4000 


(BBB) n-hexane 




(UUUU) 


trichlorofluoro- 




(CCC) hexane isomers 




methane 




except n-hexane 




(WW) 


1,1,2-tnchloro- 




(DDD) hvdra/me 




1,: 


..2-trifluoroethane 




(FEE) hydrogen chloride 




(WWWW) vmvlchlonde 


26 


FEE) hydrogen cyanide 




(XXXX) 


vinylidene chloride 




GGG) hydrogen fluonde 




(YYYY) 


xylene 




ilHH) hydrogen sulfide 










.111) lithium chromate 


0.0056 




lb/day lb hr 


lb 15 min 


(JJJ) maleic anhydride 




(A) 




1.7 


(KKK) manganese and 




(B) 




0.24 


compounds 




(C) 




0.005 


(LLL) manganese 




(D) 






cyclopentadienyl 




(E) 




0.17 


tncarbonyl 




(F) 






(MMM) manganese tetroxide 




(G) 






(NNN) mercur.-, alkyl 




(H) 


0.25 




(000) mercuPv, ar\l and 




(I) 






morgamc compounds 




(J) 






(PPP) mercur.', vapor 




(K) 


0.13 




(OOQ) methyl chloroform 




(L) 






(RRR) methylene chloride 


1600 


(M) 






(SSS) methyl ethyl ketone 




(N) 






(TTT) methyl isobutyl ketone 




(0) 


0.13 





442 



NORTH CAROLINA REGISTER 



PROPOSED RULES 



(P) 
(Q) 
(R) 
(S) 

(T) 

(U) 

(V) 

(W) 

(X) 

(Y) 

(Z) 

(AA) 

(BB) 

(CO 

(DD) 

(EE) 

(FF) 

(GG) 

(HH) 

(II) 

(JJ) 

(KK) 

(LL) 

(MM) 

(NN) 

(OO) 

(PP) 

(QO) 

(RR) 

(SS) 

(TT) 

(UU) 

(\^1 

(WW) 

(XX) 

(YY) 

(ZZ) 

(AAA) 

(BBB) 

(CCC) 

(DDD) 

(EEE) 

(FFF) 

(GGG) 

(HHH) 

(III) 

(JJJ) 

(KKK) 

(LLL) 

(MMM) 

(NNN) 

(OOO) 

(PPP) 
(OOQ) 

(RRR) 
(SSS) 
(TTT) 
(LLL) 



3.9 

0.79 
46 

9.2 



1300 
10 

0.63 
0.063 
12 



6.3 

2.5 

0.34 

0.013 

23 

0.013 

2.9 
0.63 



0.25 
0.63 
0.013 
0.13 
0.0013 
0.013 
0.013 
250 

78 
52 



0.013 



0.89 
0.56 



4.2 



36 

0.64 



0.48 

0.025 
0.64 

0.0025 



0.28 



0,025 



0.010 

23 
0.045 

0.13 



16 

5.6 

1.9 



(VW) 






(WWW) 






(XXX) 






(YYY) 


1.3 


0.13 


(ZZZ) 






(AAAA) 


0.063 


0.0064 


(BBBB) 






(CCCC) 




0.24 


(DDDD) 


0.052 




(EEEE) 






(FFFF) 






(GGGG) 






(HHHH) 






(IIII) 






(JJJJ) 






(KKKK) 






(LLLL) 


27 




(MMMM) 


0.25 


0.025 


(NNNN) 






(OOOO) 1100 




(PPPP) 1100 




(OQOO) 






(RRRR) 


98 




(SSSS) 


0.011 




(1111) 






(ULUU) 




140 


(WW) 






(WWWW) 






(XXXX) 


2.5 




(YYYY) 


57 





0.064 



0.008 



3.6 
0.001 



60 



4.1 



Statutory Authority G.S. l43-2I5.3(a)( I ): 143- 
215.108; I43B-282. 

TITLE 21 - OCCUPATIONAL LICENSLSG 
BOARD 



No 



otice is hereby given in accordance with G.S. 
I SOB- 1 2 that the North Carolina Board of Land- 
scape Architects intends to adopt rule(s) cited as 
21 NC AC 26 .0307. 

1 he proposed effective dale of this action is De- 
cember I. 1989. 

1 he public hearing will be conducted at / 1:00 
A.M. on August 3, 1989 at First Floor Conference 
Room, Caswell Building, 3700 .National Drive. 
Raleigh, NC 27612. 



Co 



0.013 



- omment Procedures: Persons wishing to pres- 
ent oral data, views, or arguments on a proposed 
rule may file a notice with the Board ai least 10 
days prior to the hearing. Any person may also 
file a written submission concerning data, com- 
ments or arguments at any time until the date of 



NORTH C.4R0LINA REGISTER 



443 



PROPOSED RULES 



the hearing. Submissions should be mailed to the 
Board at P.O. Box 26852. Raleigh. NC 27611. 

CHAPTER 26 - BOARD OF LANDSCAPE 
ARCHITECTS 

SECTION .0300 - EXAMINATION AND 
LICENSING PROCEDURES 

.0307 CONTINUING EDUCATION AS A 

CONDITION OF ANNUAL RENEWAL 

(a) In order for a licensee to qualify for license 
renewal as a Landscape Architect in North Ca- 
rolina, the licensee must have complete 10 con- 
tact hours of contmuing education within the 
previous year. Such continumg education shall 
be by actively participating in courses, seminars, 
sessions, or programs approved by the Board. 

(b) Proposed courses, seminars, sessions, or 
programs seekmg to receive approval of the 
Board shall first be submitted to a five member 
Advisory Committee of NC licensed Landscape 
Architects appomted by the Chairman of the 
Board. This Continuing Education Advisory 
Committee shall recommend any course, semi- 
nar, session or program for contmuing education 
credit to the Board that the Advisory Committee 
fmds to meet the cntena m Paragraph (b)(l)(2) 
of this Rule. Committee members shall be re- 
imbursed per diem and travel expenses for official 
meetmgs and serve purely at the discretion of the 
Chairman of the Board. No programs shall be 
considered for approval by the Board until first 
presented to the Advisory Committee for their 
recommendation . 

( 1) Each course, serrunar, session or program 
to be recommended for approval by the 
Board shall, m the opinion of at least four 
members of the Advisory Committee, 
have a direct relationship to the practice 
of Landscape ^'Xrchitecture as defined in 
Chapter 89A of the General Statutes of 



North Carolina and contam elements 
which will enhance the health, safety, and 
welfare of the atizens of North Carolina 
served by North Carolina licensed Land- 
scaf)e Architects. 
(2) The Continuing Education Advisory 
Committee shall meet at least once during 
each three month quarter of the year and 
act on each course, seminar, session, or 
program properly submitted for its review. 
Each program shall be recommended for 
approval, recommended for disapproval, 
or deferred for lack of information. Pro- 
grams recommended for approval shall be 
accompanied by a brief statement of fmd- 
ings by the committee of how the pro- 
gram meets the cnteria established by this 
Rule. Programs deferred for lack of in- 
formation shall be deferred only once, and 
if information is still lacking when next 
considered, the program shall be recom- 
mended for disapproval. Programs may 
be recommended for pre-approval by the 
Advisory Committee before they actually 
occur. 

(c) Documentation of compliance with this 
Section shall be by affidavit provided on the ap- 
plication for hcense renewal. Erroneous or false 
information attested to by the licensee shall be 
deemed as grounds for denial of license renewal 
and fX)ssible suspension of license or demal of 
consideration for future license reinstatement, at 
the discretion of the Board. 

(d) Requirements of this Section for license 
renewal shall become effective for license renewal 
on July 1, 1991. The Continumg Education 
Advisory Committee shall be appointed and 
ready to serve no later than January 1, 1990. 

Statutory Authority G.S. 89A-3(c); 89A-5. 



444 



NORTH CAROLINA REGISTER 



FINAL RULES 



U pon request from the adopting agency, the text of rules will be published in this section. 

W hen the text of any adopted rule is identical to the text of that as proposed, adoption of the rule 
will be noted in the "List of Rules Codified" and the text of the adopted rule will not be republished. 

/i dopted rules filed by the Departments of Correction, Revenue and Transportation are published 
in this section. These departments are not subject to the pravisioru ofG.S. I SOB. .Article 2 requiring 
publication of proposed rules. 

NORTH CAROLINA ADMINISTRATTV E CODE 

LIST OF RULES CODIHED 

JULY 1989 



AGENCY 

DEPARTMENT OF COMMERCE 

4 NCAC IE .0303 

13D .0101 
17 .0204 -.0205 

COLNCIL OF STATE 



ACTION TAKEN 



Amended 
Amended 
Adopted 



6 NCAC 1 .0003 
DEPARTMENT OF CLLTLRAL RESOLRCES 

7 NCAC 4Q .0101 - .0102 

.0104- .0105 
4R .0601 - .0602 
.0719 
.0901 
.0905 
.0907 
.1004 
.1013 
4T .0002 
.0007 



Amended 



Correction 
Correction 
Correction 
Correction 
Correction 
Correction 
Correction 
Correction 
Correction 
Correction 
Correction 



OFFICES OF THE GOVERNOR AND LIEUTENANT GOVERNOR 

9 NCAC 2 Executive Order Number 90 

EfT. May 18, 1989 
Executive Order Number 91 
EfT. May 18, 1989 
Executive Order Number 92 
EfT. .May 31, 1989 

DEPARTMENT OF HUMAN RESOLRCES 



NCAC 3G .2204 
.2305 
.2311 



2314 



Correction 
Correction 
Correction 



NORTH CAROLINA REGISTER 



445 







FINAL RULES 






.2401 




Correction 




.2409 




Correction 




.2449- 


.2451 


Correction 




.2510 




Correction 




.2516 




Correction 




.2610 




, Correction 




.3201 - 


.3202 


Amended 




.3205 




Amended 




.3402 




Correction 




.3407- 


.3408 


Correction 




.3411 




Correction 




.3414 




Correction 




.3419 




Correction 




.3422 




Correction 




.3424 




Correction 




.3501 




Correction 




.3503 




Correction 




.3509 




Correction 


3H 
8C 


.0516 
.0602 




Adopted 
Amended 




.0802 




Amended 




.0805 - 


.0806 


Amended 




.0808 - 


.0809 


Amended 




.0901 - 


.0902 


Amended 




.1103- 


.1104 


Amended 




.1106 




Amended 


14G 


.0101 - 


.0102 


Amended 




.0201 - 


.0212 


Amended 




.0301 - 


.0306 


Amended 


14H 


.0101 
.0102- 


.0104 


Repealed 
Amended 




.0201 - 


.0208 


Amended 




.0301 - 


.0302 


Amended 




.0401 - 


.0403 


Amended 


141 


.0101 - 


.0105 


Amended 




.0106 
.0201 - 


.0204 


Adopted 
Amended 




.0301 - 


.0308 


Amended 




.0310 




Amended 


14J 


.0101 - 


.0103 


Amended 




.0104 
.0105- 


.0106 


Repealed 
Amended 




.0107 
.0201 - 


.0207 


Adopted 
Amended 




.0208 - 
.0301 - 


.0209 
.0302 


Repealed 
Amended 




.0401 - 


.0404 


Amended 


UK 
15A 
181 


.0219 
.0204 - 
.0115 


.0228 


Adopted 
Adopted 
Amended 


18J 


.0709 




Amended 




.0712 




Amended 


18L 


.0333 - 


.0334 


Amended 




.0338 




Amended 




.0429 




Amended 




.0432 




Amended 




.0604 




Amended 




.0702 - 


.0703 


Amended 




.0705 - 


.0707 


Amended 



446 



NORTH CAROLINA REGISTER 



nNAL RULES 



.0804- 
.0903 - 
.1002 
.1004- 
.1102- 
.1203- 
.1302- 
.1402- 
18Q .0284 
.0286 
.0521 
.0709 - 
.0803 - 
.0808 
.0810 
.0812 
.0205 
.0301 
.0304 
.0101 
.0105- 
.0204 
.0001 - 
.0004- 
.0006 - 
.0009 
45G .0110 
45H .0203 
47B .0404 



18R 
35D 

35E 



35F 



.0809 
.0904 

.1006 
.1107 
,1206 
.1305 
,1403 



.0715 
.0804 



0106 

0003 
0005 
0007 



Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Adopted 

Amended 

Amended 

Amended 

Amended 

Repealed 

Amended 

Amended 

Amended 

Amended 

Adopted 

Amended 

RejTealed 

Amended 

Rep)ealed 

Amended 

Amended 

Amended 



DEPARTMENT OF INSLRANCE 



11 NCAC 13 .0504 

DEPARTMENT OF JLSTICE 



12 


NCAC 9A 


.0103 

.0204 - .0206 




9B 


.0102 

.0203 

.0205 - .0206 

.0209- .0214 

.0218- .0219 

.0222 

.0224 

.0226 - .0228 

.0231 - .0232 

.0233 

.0304 -.0305 

.0310 

.0401 

.0403 - .0407 

.0414- .0415 

.0603 




9C 


.0303 - .0304 
.0306 - .0307 
.0501 - .0505 
.0602 - .0605 




9E 


.0101 - .0107 



Amended 



Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Adopted 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Repealed 

Amended 

Adopted 



NORTH CAROLINA REGISTER 



447 



FINAL RULES 



lOB .0601 
DEPARTMENT OF LABOR 



13 



NCAC IC 



.0101 - .0102 
.0105- .0106 



Amended 



Amended 
Adopted 



DEPARTMENT OF CRIME CONTROL AND PUBLIC SAFETY 



14A NCAC 7 .0311 Amended 

DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT 



Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Repealed 
Repealed 
Repealed 
Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Amended 
Correction 



15 NCAC 7H 


.0209 


7J 


.0203 - .0204 




.0207 




.0306 




.0312 




.0402 - .0403 




.0801 - .0822 




.0901 - .0909 




.1001 - .1003 


lOB 


.0105 




.0113 




.0202 - .0203 




.0209 


IOC 


.0205 - .0206 




.0208 




.0213 




.0305 




.0401 - .0402 




.0407 


10D.0002- .0003 


lOF 


.0359 


DEPARTMENT OF PUBLIC EDUCATION 



16 NCAC 6C .0401 
DEPARTMENT OF REVENUE 

17 NCAC 7B 23 

-06 
■01 
-AJI 
.2903 
.3201 
.3203 
.3301 
7C .0103- .0104 
.0304 

BO\RD OF CERTIFIED PUBLIC ACCOUNTANT EXAMINERS 

21 NCAC 8A .0101 

.0105 
.0201 

.0308- .0310 
88 .0102 
.0501 



Amended 



Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Adopted 

Amended 

Amended 

Amended 



Correction 
Correction 
Correction 
Correction 
Correction 
Correction 



448 



NORTH CAROLINA REGISTER 



FINAL RULES 





.0508 




Correction 


8C 


.0103 




Correction 




.0107- 


.0108 


Correction 




.0110- 


.0111 


Correction 




.0114 




Correction 




.0121 




Correction 


8F 


.0101 




Correction 




.0103 




Correction 




.0106 




Correction 




.0302 




Correction 




.0304 




Correction 




.0401 




Amended 


8G 


.0101 




Correction 




.0109 




Correction 




.0112- 


.0113 


Correction 




.0201 




Correction 




.0203 - 


.0204 


Correction 




.0211 




Correction 




.0305 




Correction 




.0403 




Correction 




.0404 




Correction 


8H 


.0004- 


.0005 


Correction 


81 


.0001 - 


.0002 


Correction 




.0004 




Correction 


8J 


.0001 




Correction 




.0003 




Correction 




.0006 - 


.0007 


Correction 


8K 


.0104- 


.0105 


Correction 




.0201 




Correction 


8L 


.0002 




Correction 


BOARD OF EXAMINERS OF ELECTRICAL CONTRACTORS 




21 NCAC 18B 


.0209 




Amended 




.0404 




Amended 




.0704 




Amended 


LICENSING BOARD OF LANDSCAPE ARCHITECTS 





21 NCAC 26 .0105 Amended 

BOARD OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS 



21 NCAC 56 .0604 

.1601 - .1604 

REAL ESTATE COMMISSION 



21 



NCAC 58A .0104- .0107 
.0109 
.0112 

.0401 - .0402 
.0406 
.0501 

.1501 - .1502 
.1601 
58B .0701 



OFFICE OF STATE PERSONNEL 



Repealed 
Adopted 



Amended 

Amended 

Amended 

Amended 

Amended 

Amended 

Adopted 

Adopted 

Adopted 



NORTH CAROLINA REGISTER 



449 





FINAL RULES 




25 NCAC IB 


.0402 


Amended 




.0414 


Amended 


ID 


.0301 - .0302 


Amended 




.1201 - .1204 


Amended 


IJ 


.0408 


Amended 




.0605 


Amended 




.0608 


Amended 




.0701 - .0703 


Amended 


OFFICE OF ADMINISTRATIVE HEARINGS 




26 NCAC 2A 


.0204 


Amended 


4 


.0001 


Amended 




.0008 


Amended 



450 



NORTH CAROLINA REGISTER 



NC AC INDEX 



TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE 
TITLE DEPARTMENT 



1 

2 
3 

4 
5 
6 

7 
8 

9 
10 
11 
12 
13 
14A 
15 
16 
17 
18 
19A 
20 
*21 
22 

23 
24 
25 
26 



Administration, Department of 

Agriculture, Department of 

Auditor, Department of State 

Commerce, Department of 

Corrections, Department of 

Council of State 

Cultural Resources, Department of 

Elections, State Board of 

Governor, Office of the 

Human Resources, Department of 

Insurance, Department of 

Justice, Department of 

Labor, Department of 

Crime Control and Public Safety, Department of 

Natural Resources and Community Development, Department of 

Public Education, Department of 

Revenue, Department of 

Secretary of State, Department of 

Transportation, Department of 

Treasurer, Department of State 

Occupational Licensing Boards 

Administrative Procedures 

Commumty Colleges, Department of 

Independent Agencies 

State Personnel, Office of 

Administrative Hearings, Office of 



NOTE: Title 21 contains the chapters of the various occupational licensing boards. 



CHAPTER 

2 
4 
6 

8 
10 
12 
14 
16 
18 
20 
21 
22 

26 
28 
31 
32 
33 
34 
36 
37 
38 
40 
42 



LICENSING BOARDS 

Architecture, Board of 

Auctioneers, Commission for 

Barber Examiners, Board of 

Certified Public Accountant Examiners, Board of 

Chiropractic Examiners, Board of 

General Contractors, Licensmg Board for 

Cosmetic Art Examiners, Board of 

Dental Examiners, Board of 

Electrical Contractors, Board of Examiners of 

Foresters, Board of Registration for 

Geologists, Board of 

Hearing Aid Dealers and Fitters Board 

Landscape Architects, Licensing Board of 

Landscape Contractors, Registration Board of 

Martial & Family Therapy Certification Board 

Medical Exammers, Board of 

Midwiferv' Joint Comnuttee 

Mortuary Science, Board of 

Nursing, Board of 

Nursing Home Administrators, Board of 

Occupational Therapists, Board of 

Opticians, Board of 

Optometry, Board of Examiners in 



NORTH CAROLINA REGISTER 



451 



NC AC INDEX 



44 Osteopathic Examination and Registration, Board of 

46 Pharmacy, Board of 

48 Physical Therapy Examiners, Board of 

50 Plumbing and Heating Contractors, Board of 

52 Podiatry Examiners, Board of 

53 Practicing Counselors, Board of 

54 . Practicing Psychologists, Board of 

56 Professional Engineers and Land Surveyors, Board of 

58 Real Estate Commission 

60 Refrigeration Examiners, Board of 

62 Sanitarian Examiners, Board of 

63 Social Work, Certification Board for 

64 Speech and Language Pathologists and 

Audiologists, Board of Examiners of 

66 Veterinary Medical Board 



452 NOR TH CA ROLINA REGIS TER 



CUMULA TIVE INDEX 



CUMULA TIVE INDEX 

(April 1989 - March 1990) 



1989 - 1990 

Pages Issue 

1 - 151 1 - April 

152 - 192 2 - April 

193 - 216 3 - May 

217 - 289 4 - May 

290 - 311 5 - June 

312 - 364 6 - June 

365 - 454 7 - July 



AO - Administrative Order 

AG - Attorney General's Opinions 

C - Correction 

FR - Final Rule 

GS - General Statute 

JO - Judicial Orders or Decision 

M - Miscellaneous 

NP - Notice of Petitions 

PR - Proposed Rule 

SO - Statements of Organization 

TR - Temporary Rule 



ADMIMSTRAXrV E ORDER 

Administrative Order, 4, 152 

AGRICULTURE 

Cotton Warehouse, 220 PR 

Markets, 217 PR 

N.C. Pesticide Board, 292 PR 

N.C. Plant Conservation Board, 196 PR 

N.C. State Fair, 217 PR 

Plant Industry, 153 PR, 218 PR 

COMMERCE 

Fmance Center, 368 PR 

N.C. Cemetery Commission, 198 PR 

COMML^SITY COLLEGES 

Board of Community Colleges, 352 PR 

CULTURAL RESOURCES 

Archives and History, 370 PR 
Arts Council, 371 PR 

EDUCATION 



NOR TH CA ROLINA REGIS TER 453 



CUMULA TIVE INDEX 



Elementary- and Secondar>' Education, 253 PR, 295 PR 

FINAL DECISION LETTERS 

Voting Rights Act, 5, 193, 367 

FINAL RULES 

List of Rules Codified, 183 FR, 274 FR, 303 FR, 445 FR 

GO\ ERNOR/LT. GOVERNOR 

Executive Orders, 1, 290, 312, 365 

HLMAN RESOURCES 

Departmental Rules, 372 PR 

Facility Semces, 199 PR, 377 PR 

Health Services, 153 PR, 315 PR, 405 PR 

Medical Assistance, 158 PR, 294 PR 

Mental Health: Mental Retardation and Substance Abuse Services, 17 PR, 417 PR 

Vocational Rehabilitation Services, 7 PR 

INSURANCE 

Fire and Casualty Division, 202 PR 

LICENSrSG BOARDS 

Architecture, 349 PR 

Landscape .Architects, 443 PR 

North Carolina Certification Board for Social Work, 179 PR 

Nursing, Board of 296 PR 

Physical Therapy Examiners, 262 PR 

NATURAL RESOURCES AND COMMUN,ITY DEVELOPMENT 

Coastal Management, 239 PR 

Commumty Assistance, 134 PR 

Economic Opportunity, 178 PR 

Envu-onmental Management, 18 PR, 160 PR, 202 PR, 238 PR, 295 PR, 347 PR, 431 PR 

Marine Fisheries. 47 PR 

Wildlife Resources and Water Safety, 134 PR, 178 PR, 207 PR, 252 PR 

RE\ENUE 

Sales and Use Tax, 353 FR 

STATE PERSONN.EL 

State Personnel Commission, 181 PR, 210 PR, 265 PR 

TRANSPORTATION 

Division of Motor Vehicles, 140 FR 



454 NOR TH CA ROUS A REGIS TER 



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